Individual provider Active NPI

Kurt Ryan Bjorkman, M.D.

  • Pediatric Cardiology Physician
  • Grand Rapids, MI
National Provider Identifier
1609254499
Registry record updated Nov 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
4301509851 Issued in MI
Practice address
25 Michigan St NE Ste 4200
Grand Rapids, MI 49503-2559
Phone
(616) 267-9150
NPI assigned
May 12, 2015
Last updated
Nov 10, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 4301509851 MI Primary

Addresses

Primary practice location

25 Michigan St NE Ste 4200
Grand Rapids, MI 49503-2559

Mailing address

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

Other practice location 1

1105 Sixth St
Traverse City, MI 49684-2345
Phone (231) 935-6370

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
I20230828000986 MI Practitioner - Pediatric Medicine 7719299940 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
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

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301509851MIMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Hospitals at Niles and St Joseph, Inc CurrentSince Sep 19, 2023 Accepting new patients
Munson Medical Center CurrentSince Nov 12, 2023 Accepting new patients
Munson Medical Center Current Accepting new patients
Spectrum Health Primary Care Partners Pediatric Cardiology CurrentSince Sep 1, 2023 Accepting new patients
Munson Medical Center Pediatrics CurrentSince Nov 12, 2023 Accepting new patients
Lakeland Hospitals at Niles and St Joseph, Inc CurrentSince Sep 19, 2023 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Sep 1, 2023 Accepting new patients
Spectrum Health Hospitals Past Accepting new patients

Locations

2513 Momentum Pl
Chicago, IL 60689
Phone (231) 935-8031

25 Michigan St NE
Ste 4200
Grand Rapids, MI 49503
Phone (616) 267-9150

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

3950 Hollywood Rd
Ste 240
Saint Joseph, MI 49085
Phone (269) 428-4411

1234 Napier Ave
Saint Joseph, MI 49085
Phone (269) 982-4941

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

3333 Burnet Ave
#C4
Cincinnati, OH 45229
Phone (513) 636-4432

3333 Burnet Ave
Cincinnati, OH 45229
Phone (513) 636-4200

Interoperability endpoints

  • Direct secure messaging: kbjorkman1280910@epic00.corewelldirect.org

Organizations & group practices 9

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

NPI Registry JSON

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

{
    "created_epoch": "1431388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699574400000",
    "number": "1609254499",
    "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": "25 MICHIGAN ST NE STE 4200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032559",
            "telephone_number": "616-267-9150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1105 Sixth St",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496842345",
            "country_code": "US",
            "telephone_number": "231-935-6370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BJORKMAN",
        "first_name": "KURT",
        "middle_name": "RYAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-12",
        "last_updated": "2023-11-10",
        "certification_date": "2023-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "MI",
            "license": "4301509851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.