Individual provider Active NPI

John Dykstra, DO

  • Family Medicine Physician
  • Hudsonville, MI
National Provider Identifier
1730177379
Registry record updated Dec 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101013345 Issued in MI
Practice address
3912 32ND Ave
Hudsonville, MI 49426-8460
Phone
(616) 252-8700
Fax
(616) 252-8750
NPI assigned
Oct 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101013345 MI Primary

Addresses

Primary practice location

3912 32ND Ave
Hudsonville, MI 49426-8460

Mailing address

5900 Byron Center Ave SW
Attn: Medical Administration
Wyoming, MI 49519-9606

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
I20040329000052 MI Practitioner - Family Practice 7315839990 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Chicago College of Osteopathy, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metropolitan HospitalGroup PAC ID 5597651836, 421 clinicians

Practice addresses (Care Compare)

3912 32ND Ave
Hudsonville, MI 49426-8460
Phone (616) 252-8700

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners CurrentSince Feb 1, 2012 Accepting new patients
Metropolitan Hospital CurrentSince Jun 1, 2016 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Feb 1, 2012 Accepting new patients
Spectrum Health Primary Care Partners Current Accepting new patients
Metropolitan Hospital Past Accepting new patients
Emergency Care Specialists PC PastSince Apr 1, 2020 Accepting new patients

Locations

4200 Division Ave N
Comstock Park, MI 49321
Phone (616) 252-1600

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

2249 Wealthy St SE
Ste 110
Grand Rapids, MI 49506
Phone (616) 391-4600

3152 Port Sheldon St
Hudsonville, MI 49426
Phone (616) 669-3558

3912 32nd Ave
Hudsonville, MI 49426
Phone (616) 252-8700

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

5950 Metro Way SW
Wyoming, MI 49519
Phone (616) 252-8100

5900 Byron Center Ave SW
Wyoming, MI 49519
Phone (616) 252-3243

2215 44th St SW
Ste 100
Wyoming, MI 49519
Phone (616) 252-8300

100 Pine St
Zeeland, MI 49464
Phone (616) 748-2850

Interoperability endpoints

  • Direct secure messaging: jdykstra60461@direct.metrohealth.net

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 3

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": "1128643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512086400000",
    "number": "1730177379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 BYRON CENTER AVE SW",
            "address_2": "ATTN: MEDICAL ADMINISTRATION",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3912 32ND AVE",
            "city": "HUDSONVILLE",
            "state": "MI",
            "postal_code": "494268460",
            "telephone_number": "616-252-8700",
            "fax_number": "616-252-8750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYKSTRA",
        "first_name": "JOHN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-07",
        "last_updated": "2017-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101013345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudsonville, MI

Sources for this page

Verify at the official NPI Registry.