Brian J Decker, MD
Individual provider Active NPI Family Medicine Physician · Jenison, MI
NPI 1801809157 · NPPES record last updated Sep 12, 2012
Key facts
- NPI
- 1801809157
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 4301084359 (MI)
- Practice address
- 7782 20TH Ave
Jenison, MI 49428 - Phone
- (616) 685-8700
- NPI assigned
- Aug 15, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Michigan State University College of Human Medicine, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Advantage Health/Saint Mary'S Medical Group
Center for Physical Rehabilitation Inc
Center for Physical Rehabilitation and Therapy LP
Practice addresses (Care Compare)
10047 Crossroad CT SE
Caledonia, MI 49316-7316
Phone (616) 685-8850
3925 32ND Ave
Suite 300
Hudsonville, MI 49426-8495
Phone (616) 685-1500
5060 Cascade Rd
Suite a
Grand Rapids, MI 49546-3808
5060 Cascade Rd SE
Suite a
Grand Rapids, MI 49546-3808
Hospital & facility affiliations
- Mercy Health Saint Mary'S
- Trinity Health Muskegon Hospital
- Mary Free Bed Rehabilitation Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060901000170 | MI | Practitioner - Family Practice | 9335143429 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advantage Health/Saint Mary'S Medical Group | Current |
Accepting new patients | |
| Advantage Health Saint Mary'S Medical Group | Current |
Accepting new patients | |
| Advantage Health Convenient Care PLLC | Past | Accepting new patients | |
| Advantage Health Physicians PC | Family Medicine | Past | Accepting new patients |
| Advantage Health Saint Mary'S Medical Group | Past | Accepting new patients |
Locations
10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850
245 State St SE
Grand Rapids, MI 49503
Phone (616) 685-1808
245 State St SE
Ste 1A
Grand Rapids, MI 49503
3380 44th St SW
Grandville, MI 49418
Phone (616) 685-8250
3925 32nd Ave
Ste 300
Hudsonville, MI 49426
Phone (616) 685-1500
7782 20th Ave
Jenison, MI 49428
Phone (616) 685-8700
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 4301084359 | MI | Yes |
Addresses
Primary practice location
7782 20TH Ave
Jenison, MI 49428
Mailing address
245 State St SE
Grand Rapids, MI 49503
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4301084359 | Other | MI | STATE LICENSE NUMBER |
Other providers in Jenison, MI
- Stephen Mitchael Dadd
- Elisabeth Dahl
- Daniel D Seitz DDS PC
- Nicholas Ruben Debernardi
- Kyler Ross Debruyn
- Emma Deglopper
- Caitlyn Dehaan
- Joann Imelda Dehoek
- Kyle Dejong
- Roger Dejonge
All providers in Jenison, MI · Family Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 12, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.