Individual provider Active NPI

Jobin Jose Philip, MD

  • Emergency Medicine Physician
  • Grand Rapids, MI
National Provider Identifier
1558820431
Registry record updated Feb 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
4301507041 Issued in MI
Practice address
100 Michigan St NE
Grand Rapids, MI 49503-2560
Phone
(616) 988-8220
Fax
(616) 957-3320
NPI assigned
Mar 19, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4301507041 MI Primary
Anesthesiology Physician 207L00000X 4301507041 MI

Addresses

Primary practice location

100 Michigan St NE
Grand Rapids, MI 49503-2560

Mailing address

4100 Embassy Dr SE Ste 400
Grand Rapids, MI 49546-2416
Phone (616) 975-1845

Other practice location 1

110 S Paca St Ste 200
Baltimore, MD 21201-1668
Phone (248) 719-6556

Other practice location 2

22 S Greene St
Baltimore, MD 21201-1544
Phone (410) 328-8025

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220902000878 MI Practitioner - Emergency Medicine 8325370844 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Michigan State University College of Human Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ecs Western Michigan PCGroup PAC ID 8628327384, 202 clinicians

Practice addresses (Care Compare)

605 Oak St
Big Rapids, MI 49307-2048
Phone (231) 796-8691

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.48 of 100Reported as group
Quality
89.26
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
92.11 of 100Reported as group
Quality
81.85
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301507041MIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rightcare Clinic PC CurrentSince Apr 1, 2024 Accepting new patients
Ecs Central Michigan PC Emergency Medicine CurrentSince Aug 1, 2022 Accepting new patients
Memorial Hospital Anesthesiology CurrentSince Apr 29, 2025 Accepting new patients
Memorial Hospital Anesthesiology CurrentSince Apr 29, 2025 Accepting new patients
Ecs Western Michigan PC Anesthesiology CurrentSince Aug 1, 2022 Accepting new patients
Visionary Medical Services PC Anesthesiology CurrentSince Jan 17, 2025 Accepting new patients

Locations

605 Oak St
Big Rapids, MI 49307
Phone (231) 592-1079

743 E Beltline Ave NE
Grand Rapids, MI 49525
Phone (616) 456-9553

1840 Wealthy St SE
Grand Rapids, MI 49506
Phone (616) 391-1730

100 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1680

4100 Embassy Dr SE
Ste 400
Grand Rapids, MI 49546
Phone (616) 285-8075

615 S Bower St
Greenville, MI 48838
Phone (616) 754-4341

826 W King St
Owosso, MI 48867
Phone (989) 720-2273

3337 Britton Rd
Perry, MI 48872
Phone (517) 625-3004

Organizations & group practices 6

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 4

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": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740700800000",
    "number": "1558820431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 EMBASSY DR SE STE 400",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462416",
            "telephone_number": "616-975-1845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-988-8220",
            "fax_number": "616-957-3320"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 S Paca St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212011668",
            "country_code": "US",
            "telephone_number": "248-719-6556",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "22 S Greene St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212011544",
            "country_code": "US",
            "telephone_number": "410-328-8025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILIP",
        "first_name": "JOBIN",
        "middle_name": "JOSE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-19",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301507041",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301507041",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.