Michael Barry Gellis, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

4301030689 Issued in MI

Practice address

205 N East Ave
Jackson, MI 49201-1753

Phone

(313) 874-4806

Fax

(313) 876-1305

NPI assigned

Mar 8, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Snake River Plastic Surgery LLC

  • Specialist
  • Jackson, WY
  • NPI 1104137074
  NPD (past) Authorized official
• W. a. Foote Memorial Hospital, Inc

  • Internal Medicine Physician
  • Jackson, MI
  • NPI 1760437826
  NPD

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1508997032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36800 WOODWARD AVE STE 109",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483040916",
            "telephone_number": "248-642-4846",
            "fax_number": "248-642-5313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N EAST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011753",
            "telephone_number": "313-874-4806",
            "fax_number": "313-876-1305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "36800 Woodward Ave",
            "address_2": "Suite 109",
            "address_purpose": "LOCATION",
            "city": "Bloomfield Hills",
            "state": "MI",
            "postal_code": "483040915",
            "country_code": "US",
            "telephone_number": "248-642-4846",
            "fax_number": "248-642-5313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GELLIS",
        "first_name": "MICHAEL",
        "middle_name": "BARRY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "WY",
            "license": "2735A",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NC",
            "license": "30028",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MI",
            "license": "4301030689",
            "primary": true
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "PA",
            "license": "MD430264",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101090399",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caren A Gayle, LCSW
• Bezawit Girma Gebre, MD
• Dawn Marie Geiger, D.C.
• Devynn Lorraine Geisenhaver
• Elizabeth Geisler, MSW
• Gems of Jackson Child Care & Education Center LLC
• Deanna Genco
• Genesis Homes of Jackson Inc.
• Genoa Healthcare LLC
• Anthony Edward Gensterblum, PHD

• Plastic Surgery Physician in Jackson, MI
• Providers in Jackson, MI by specialty
• Plastic Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.