Timothy Russel Jelsema, MD

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

4301110558 Issued in MI

Practice address

705 Oak St Unit 11
Big Rapids, MI 49307-3108

Phone

(231) 592-1002

NPI assigned

Jun 27, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

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

Family PracticeAlso: Emergency Medicine

Education

Wayne State University School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mecosta County Medical Center 53 clinicians

Spectrum Health Primary Care Partners 2,283 clinicians

Memorial Medical Center of West Michigan 62 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Corewell Health Big Rapids Hospital Hospital, Big Rapids, MI, CCN 230093
• Corewell Health Reed City Hospital Hospital, Reed City, MI, CCN 231323

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tjelsema113198@epic00.corewelldirect.org

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.

• Mecosta County Medical Center

  • Cardiovascular Disease Physician
  • Big Rapids, MI
  • NPI 1386693471

  MI

  Medicare reassignment Care Compare group NPD
• Spectrum Health Primary Care Partners

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1235188673

  MI

  Medicare reassignment Care Compare group NPD
• Reed City Hospital Corporation

  • Family Medicine Physician
  • Reed City, MI
  • NPI 1831253798

  Family Medicine, MI

  Medicare reassignment NPD
• Mecosta County Medical Center

  • General Acute Care Hospital
  • Big Rapids, MI
  • NPI 1316945991
  Care Compare group NPD
• Mecosta County Medical Center

  • Rural Health Clinic/Center
  • Big Rapids, MI
  • NPI 1184912396
  Care Compare group
• Mecosta County Medical Center

  • Rural Health Clinic/Center
  • Canadian Lakes, MI
  • NPI 1477973493
  Care Compare group
• Mecosta County Medical Center

  • Rural Health Clinic/Center
  • Evart, MI
  • NPI 1669935615
  Care Compare group
• Mecosta County Medical Center

  • Rural Health Clinic/Center
  • Big Rapids, MI
  • NPI 1891109591
  Care Compare group
• Memorial Medical Center of West Michigan

  • Rural Health Clinic/Center
  • Ludington, MI
  • NPI 1346628518
  Care Compare group
• Memorial Medical Center of West Michigan

  • Rural Health Clinic/Center
  • Ludington, MI
  • NPI 1538528872
  Care Compare group
• Memorial Medical Center of West Michigan

  • Rural Health Clinic/Center
  • Hesperia, MI
  • NPI 1730642794
  Care Compare group
• Memorial Medical Center of West Michigan

  • Rural Health Clinic/Center
  • Hart, MI
  • NPI 1861800674
  Care Compare group

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

• Mecosta County Medical Center

  • General Acute Care Hospital
  • Big Rapids, MI
  • NPI 1316945991

  Hospital

  Care Compare affiliation
• Reed City Hospital Corporation

  • Critical Access Hospital
  • Reed City, MI
  • NPI 1437259843

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1466985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613520000000",
    "number": "1871944397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 OAK ST UNIT 11",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493073108",
            "telephone_number": "231-592-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JELSEMA",
        "first_name": "TIMOTHY",
        "middle_name": "RUSSEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-27",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301110558",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "MI",
            "license": "4301110558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "705 Oak St Unit 11",
            "city": "Big Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "493073108",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tjelsema113198@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "705 Oak St Unit 11",
            "city": "Big Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "493073108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jennifer Irvine-Lebo
• Eryn Isaacson
• Amanda Rachelle Jackson
• Bonita Jacque, RPH
• Tammy L Jamett-Yount, PHARM D
• Carissa J Jenema, DPT, PT
• Alison Marie Jenerou, OD
• Jenna Jenkins, PHARMD
• John Garlick D.D.S., P.C.
• John N Campbell MD PC

• All providers in Big Rapids, MI
• Sports Medicine (Family Medicine) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2021; 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.