Individual provider Active NPI

Noah Jeffrey Jentzen, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • Grand Rapids, MI
National Provider Identifier
1508109034
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
4301509355 Issued in MI
Practice address
100 Michigan St NE Ste 8861
Grand Rapids, MI 49503-2560
Phone
(616) 391-6588
NPI assigned
Apr 3, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 4301509355 MI Primary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 86559 GA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 57403 TN

Addresses

Primary practice location

100 Michigan St NE Ste 8861
Grand Rapids, MI 49503-2560

Mailing address

100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, GA, MI3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20180723000395 TN Practitioner - Critical Care (Intensivists)Practitioner - Internal Medicine 8820345804 Reassigns benefits to 1 organization
I20200909000543 GA Practitioner - Critical Care (Intensivists)Practitioner - Internal Medicine 8820345804 Reassigns benefits to 2 organizations
I20230531000321 MI Practitioner - Internal Medicine 8820345804 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spectrum Health Primary Care PartnersGroup PAC ID 4587568647, 2,283 clinicians

Practice addresses (Care Compare)

100 Michigan Ave NE
Grand Rapids, MI 49503-2560

100 Michigan St NE RM
280 Corewell Health Medical Group West
Grand Rapids, MI 49503-2560
Phone (616) 267-0115

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

Hospital & facility affiliations

  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners CurrentSince Jun 30, 2023 Accepting new patients
The Metrohealth System Current Accepting new patients
Chattanooga Hamilton County Hospital Authority CurrentSince Aug 1, 2018 Accepting new patients
Hamilton Physician Group Inc CurrentSince Sep 10, 2020 Accepting new patients
Chattanooga Hamilton County Hospital Authority CurrentSince Aug 1, 2018 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jun 30, 2023 Accepting new patients
Pittsburgh Critical Care Associates, Inc Critical Care Medicine CurrentSince Sep 1, 2020 Accepting new patients
Hamilton Medical Center, Inc. CurrentSince Nov 1, 2020 Accepting new patients

Locations

1200 Memorial Dr
Dalton, GA 30720
Phone (706) 272-6115

1436 Broadrick Dr
Ste B
Dalton, GA 30720
Phone (706) 226-3434

100 Michigan St NE
Ste 8861
Grand Rapids, MI 49503
Phone (616) 391-2802

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

979 E 3rd St
Ste C735
Chattanooga, TN 37403
Phone (423) 778-9101

975 E 3rd St
Chattanooga, TN 37403
Phone (423) 266-1499

Interoperability endpoints

  • Direct secure messaging: njentzen122921@direct.metrohealth.org
  • Direct secure messaging: njentzen1265079@epic00.corewelldirect.org

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1364947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1508109034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE STE 8861",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-391-6588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENTZEN",
        "first_name": "NOAH",
        "middle_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-03",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MI",
            "license": "4301509355",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "GA",
            "license": "86559",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "TN",
            "license": "57403",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.