Individual provider Active NPI

Brian K Petroelje, MD

  • Infectious Disease Physician
  • Grand Rapids, MI
National Provider Identifier
1801823950
Registry record updated Feb 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
4301086846 Issued in MI
Practice address
230 Michigan St NE
Suite 230
Grand Rapids, MI 49503-2550
Phone
(616) 774-2822
Fax
(616) 391-8665
NPI assigned
Jun 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 4301086846 MI Primary

Addresses

Primary practice location

230 Michigan St NE
Suite 230
Grand Rapids, MI 49503-2550

Mailing address

100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560
Phone (616) 774-2822

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/
Direct Messaging Address Brian.Petroelje@epic00.shdirect.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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051101001037 MI Practitioner - Infectious DiseasePractitioner - Internal Medicine 5991722597 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Wayne State University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
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

1009 W Green St
Corewell Health Medical Group West
Hastings, MI 49058-1710
Phone (269) 945-1212

1840 Wealthy St SE
Corewell Health Medical Group West
Grand Rapids, MI 49506-2921
Phone (616) 885-5000

212 S Sullivan Ave
Corewell Health Medical Group West
Fremont, MI 49412-1548
Phone (616) 391-3139

2249 Wealthy St SE
110 Corewell Health Medical Group West
East Grand Rapids, MI 49506-3055
Phone (616) 391-4600

230 Michigan St NE
230 Corewell Health Medical Group West
Grand Rapids, MI 49503-2550
Phone (616) 774-2822

5 Atkinson Dr
302 Corewell Health Medical Group West
Ludington, MI 49431-1906
Phone (616) 267-8700

615 S Bower St
Greenville, MI 48838-2614
Phone (616) 225-6522

8333 Felch St
Zeeland, MI 49464-2608

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners CurrentSince Oct 8, 2008 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Oct 8, 2008 Accepting new patients

Locations

230 W Oak St
Fremont, MI 49412
Phone (231) 924-1305

1900 Wealthy St SE
Ste 100
Grand Rapids, MI 49506
Phone (616) 267-7333

221 Michigan St NE
Ste 406
Grand Rapids, MI 49503
Phone (616) 391-5701

230 Michigan St NE
Ste 230
Grand Rapids, MI 49503
Phone (616) 391-3777

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

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

1840 Wealthy St SE
Grand Rapids, MI 49506
Phone (616) 391-1730

Interoperability endpoints

  • Direct secure messaging: bpetroelje6755@epic00.corewelldirect.org
  • Direct secure messaging: brian.petroelje@epic00.shdirect.org

Organizations & group practices 2

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 4

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": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1801823950",
    "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",
            "telephone_number": "616-774-2822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 MICHIGAN ST NE",
            "address_2": "SUITE 230",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032550",
            "telephone_number": "616-774-2822",
            "fax_number": "616-391-8665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROELJE",
        "first_name": "BRIAN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MI",
            "license": "4301086846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "230 Michigan St NE",
            "address_2": "Suite 230",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495032550",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Brian.Petroelje@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "230 Michigan St NE",
            "address_2": "Suite 230",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495032550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.