Matthew Tanis, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

5101020029 Issued in MI

Practice address

80 68TH St SE
Grand Rapids, MI 49548-6980

Phone

(616) 486-5111

NPI assigned

Jun 19, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Emergency Medicine

Education

Michigan State University College of Osteopathic Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Certified Emergency Medicine Specialists PCGroup PAC ID 6204802895, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Michigan Health - West Hospital, Wyoming, MI, CCN 230236

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Certified Emergency Medicine Specialists, PC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Wyoming, MI
  • NPI 1104985001
  Medicare reassignment Care Compare group
• Metropolitan Hospital

  • Internal Medicine Physician
  • Wyoming, MI
  • NPI 1811937519
  Medicare reassignment NPD
• Sound Physicians Emergency Medicine of Michigan, PLLC

  • Emergency Medicine Physician
  • Adrian, MI
  • NPI 1568913473
  Medicare reassignment NPD
• Hometown Urgent Care of Michigan, P.C.

  • Urgent Care Clinic/Center
  • Huber Heights, OH
  • NPI 1790030385

  MI

  Medicare reassignment
• Hometown Urgent Care of Michigan, P.C.

  • Clinical Medical Laboratory
  • Kalamazoo, MI
  • NPI 1891469631
  NPD
• Metropolitan Hospital

  • Urgent Care Clinic/Center
  • Grand Rapids, MI
  • NPI 1720590961
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Metropolitan Hospital

  • General Acute Care Hospital
  • Wyoming, MI
  • NPI 1619923919
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412899200000",
    "number": "1851654487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # 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": "80 68TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495486980",
            "telephone_number": "616-486-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANIS",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-19",
        "last_updated": "2014-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101020029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1851654487",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Evan Tanguay
• Cody Jay Tanis
• Elizabeth Tanis, DPT
• Jean Tashina Tanis
• Jennifer Tanis, LMSW
• Trisha Nichole Tanis, PHD
• John Mitchell Tanja, OTR
• Tank Consultation PLLC
• Evan Tank, DO
• Sinan Sean Tankut, M.D.

• Emergency Medicine Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Emergency Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2014; 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.

Verify at the official NPI Registry.