Individual provider Active NPI

Yelena Yavich, MD

  • Internal Medicine Physician
  • Grand Rapids, MI
National Provider Identifier
1780630772
Registry record updated Jun 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301062451 Issued in MI
Practice address
4100 Lake Dr SE
S-200
Grand Rapids, MI 49546-8292
Phone
(616) 974-4820
NPI assigned
May 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301062451 MI Primary

Addresses

Primary practice location

4100 Lake Dr SE
S-200
Grand Rapids, MI 49546-8292

Mailing address

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

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
I20040928000976 MI Practitioner - Internal Medicine 3476522327 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Center for Physical Rehabilitation IncGroup PAC ID 6901717768, 352 clinicians
Center for Physical Rehabilitation and Therapy LPGroup PAC ID 0941513303, 365 clinicians

Practice addresses (Care Compare)

5060 Cascade Rd
Suite a
Grand Rapids, MI 49546-3808

5060 Cascade Rd SE
Suite a
Grand Rapids, MI 49546-3808

Hospital & facility affiliations

  • Mary Free Bed at Home, LLC Home health agency, Grand Rapids, MI, CCN 237203
  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301062451MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners Internal Medicine Current Accepting new patients
Spectrum Health Primary Care Partners Internal Medicine CurrentSince Jan 1, 2011 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jan 1, 2011 Accepting new patients
Baxter Community Center CurrentSince Dec 21, 2010 Accepting new patients

Locations

4069 Lake Dr SE
Ste 117
Grand Rapids, MI 49546
Phone (616) 267-8600

4085 Burton St SE
Ste 200
Grand Rapids, MI 49546

935 Baxter St SE
Grand Rapids, MI 49506
Phone (616) 215-4544

4100 Lake Dr SE
#S200
Grand Rapids, MI 49546
Phone (616) 949-8244

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

1300 Michigan St NE
Ste 103
Grand Rapids, MI 49503
Phone (616) 459-8338

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

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

602 Michigan Ave
Holland, MI 49423
Phone (616) 394-3350

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

4310 Leonard St NW
Ste 103
Walker, MI 49534
Phone (616) 453-0600

Interoperability endpoints

  • Direct secure messaging: yyavich532@epic00.corewelldirect.org
  • Direct secure messaging: yelena.yavich@epic00.shdirect.org

Organizations & group practices 5

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": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781568000000",
    "number": "1780630772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 LAKE DR SE",
            "address_2": "S-200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468292",
            "telephone_number": "616-974-4820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAVICH",
        "first_name": "YELENA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2026-06-16",
        "certification_date": "2026-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301062451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.