Active NPI
Lara Mariel Osetinsky, M.D.
- Otolaryngology Physician
- Grand Rapids, MI
National Provider Identifier
1609283936
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 4301517179
- Practice address
- 4069 Lake Dr SE Ste 315
Grand Rapids, MI 49546-8816 - Phone
- (616) 267-7758
- NPI assigned
- Jul 18, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 4301517179 | MI | Primary |
Addresses
Primary practice location
4069 Lake Dr SE Ste 315
Grand Rapids, MI 49546-8816
Mailing address
100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560
Other names 1
- Dr. L. Mariel Osetinsky
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/ | ||
| Direct Messaging Address | mfrisch3534190@epic00.corewelldirect.org |
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
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260618000340 | MI | Practitioner - Otolaryngology | 2062631575 |
Care Compare profile
Medicare Care Compare- Specialty
- Otolaryngology
- Education
- University of Kentucky College of Medicine, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4069 Lake Dr SE
Grand Rapids, MI 49546-8816
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
| License | State | Type | Specialty |
|---|---|---|---|
| 52806 | KY | MD | Otolaryngology Physician |
| 1609283936 | MN | MD | Otolaryngology Physician |
Organizations & group practices 1
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783382400000",
"number": "1609283936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 MICHIGAN ST NE",
"address_2": "MC 845",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495032560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4069 LAKE DR SE STE 315",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495468816",
"telephone_number": "616-267-7758"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OSETINSKY",
"first_name": "LARA",
"middle_name": "MARIEL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-18",
"last_updated": "2026-07-07",
"certification_date": "2026-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "MI",
"license": "4301517179",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/",
"affiliation": "N",
"address_1": "4069 Lake Dr SE Ste 315",
"city": "Grand Rapids",
"state": "MI",
"country_code": "US",
"postal_code": "495468816",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mfrisch3534190@epic00.corewelldirect.org",
"affiliation": "N",
"address_1": "4069 Lake Dr SE Ste 315",
"city": "Grand Rapids",
"state": "MI",
"country_code": "US",
"postal_code": "495468816",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "L. MARIEL",
"last_name": "OSETINSKY",
"prefix": "DR.",
"credential": "M.D.",
"code": "5",
"type": "Other Name"
}
]
}
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 Jul 7, 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.
- 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.