Active NPI
Tia Chakraborty, M.D.
- Neurocritical Care Physician
- Grand Rapids, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurocritical Care Physician
- License
- 4301501463
- Practice address
- 100 Michigan St NE # Mc019
Grand Rapids, MI 49503-2560 - Phone
- (616) 486-0310
- NPI assigned
- Jul 15, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 4301501463 | MI | |
| Neurocritical Care Physician | 2084A2900X | 4301501463 | MI | Primary |
Addresses
Primary practice location
100 Michigan St NE # Mc019
Grand Rapids, MI 49503-2560
Mailing address
100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tchakraborty264814@epic00.shdirect.org | ||
| FHIR URL | https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Neurology
- Education
- Wayne State University School of Medicine, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
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
212 S Sullivan Ave
Corewell Health Medical Group West
Fremont, MI 49412-1548
Phone (616) 391-3139
275 Michigan St NE
Grand Rapids, MI 49503-2531
Phone (616) 267-8700
4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600
5 Atkinson Dr
302 Corewell Health Medical Group West
Ludington, MI 49431-1906
Phone (616) 267-8700
605 Oak St
Big Rapids, MI 49307-2048
Phone (231) 592-4270
8333 Felch St
Zeeland, MI 49464-2608
Hospital & facility affiliations
- Corewell Health Hospice & Palliative Care - West Michigan
- Spectrum Health
- Corewell Health Zeeland Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spectrum Health Primary Care Partners | Current | Accepting new patients | |
| Lakeland Medical Practices | Current | Accepting new patients | |
| Spectrum Health Primary Care Partners | Current | Accepting new patients | |
| Lakeland Medical Practices | Current | Accepting new patients |
Locations
100 Michigan St NE
#19
Grand Rapids, MI 49503
Phone (616) 391-1969
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
1234 Napier Ave
Saint Joseph, MI 49085
Phone (269) 982-4941
3950 Hollywood Rd
Ste 280
Saint Joseph, MI 49085
Phone (269) 408-0990
Interoperability endpoints
- tchakraborty264814@epic00.shdirect.org
- tchakraborty264814@epic00.corewelldirect.org
Organizations & group practices 4
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.
-
- Internal Medicine Physician
- Grand Rapids, MI
- NPI 1235188673
-
- Internal Medicine Physician
- Saint Joseph, MI
- NPI 1538397120
-
- Internal Medicine Physician
- Bridgman, MI
- NPI 1568232247
-
- Internal Medicine Physician
- Grand Rapids, MI
- NPI 1689499667
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Hastings, MI
- NPI 1932695525
-
- Community Based Hospice Care Agency
- Grand Rapids, MI
- NPI 1225012099
-
- General Acute Care Hospital
- Grand Rapids, MI
- NPI 1922090554
-
- General Acute Care Hospital
- Zeeland, MI
- NPI 1275536344
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659916800000",
"number": "1548677263",
"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 # MC019",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495032560",
"telephone_number": "616-486-0310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAKRABORTY",
"first_name": "TIA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-15",
"last_updated": "2022-08-08",
"certification_date": "2022-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "MI",
"license": "4301501463",
"primary": false
},
{
"code": "2084A2900X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurocritical Care",
"state": "MI",
"license": "4301501463",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "tchakraborty264814@epic00.shdirect.org",
"affiliation": "N",
"address_1": "100 Michigan St NE # Mc019",
"city": "Grand Rapids",
"state": "MI",
"country_code": "US",
"postal_code": "495032560",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "100 Michigan St NE # Mc019",
"city": "Grand Rapids",
"state": "MI",
"country_code": "US",
"postal_code": "495032560",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.