NPIMap

Individual provider Active NPI

Ryan John Gleesing, D.O.

  • Family Medicine Physician
  • Clinton Township, MI
National Provider Identifier
1851688139
Registry record updated Jan 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101019373 Issued in MI
Practice address
43900 Garfield Rd
Suite 222
Clinton Township, MI 48038-1128
Phone
(586) 286-0050
Fax
(586) 286-0880
NPI assigned
Jul 7, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101019373 MI Primary
Sports Medicine (Family Medicine) Physician 207QS0010X 5101019373 MI

Addresses

Primary practice location

43900 Garfield Rd
Suite 222
Clinton Township, MI 48038-1128

Mailing address

43900 Garfield Rd
Suite 222
Clinton Township, MI 48038-1128
Phone (586) 286-0050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150714000260 MI Practitioner - Family PracticePractitioner - Sports Medicine 9537472097 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
Michigan State University College of Osteopathic Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Semi Medical GroupGroup PAC ID 0648180406, shared by 4 NPIs, 246 clinicians
Henry Ford Cornerstone Medical GroupGroup PAC ID 7517162761, 65 clinicians

Practice addresses (Care Compare)

17900 23 Mile Rd
Macomb, MI 48044-1161
Phone (313) 647-3900

43900 Garfield Rd
Suite 222
Clinton Township, MI 48038-1137
Phone (586) 286-0050

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101019373MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Cornerstone Medical Group Family Medicine CurrentSince Jan 1, 2016 Accepting new patients

Locations

4260 Van Dyke Rd
Ste 102
Almont, MI 48003
Phone (810) 798-3994

43900 Garfield Rd
Ste 222
Clinton Twp, MI 48038
Phone (586) 263-1234

46591 Romeo Plank Rd
Macomb, MI 48044
Phone (586) 226-6269

Interoperability endpoints

  • Direct secure messaging: rgleesing432056@direct.hfhs.org
  • Direct secure messaging: ryan.gleesing.3@8209.direct.athenahealth.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/mQjCqHb5rkr1u1foU4dqhQPBpi7Qk9R4/

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1309996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484179200000",
    "number": "1851688139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43900 GARFIELD RD",
            "address_2": "SUITE 222",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381128",
            "telephone_number": "586-286-0050",
            "fax_number": "586-286-0880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43900 GARFIELD RD",
            "address_2": "SUITE 222",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381128",
            "telephone_number": "586-286-0050",
            "fax_number": "586-286-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLEESING",
        "first_name": "RYAN",
        "middle_name": "JOHN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-07",
        "last_updated": "2017-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101019373",
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "MI",
            "license": "5101019373",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

Verify at the official NPI Registry.