Charles L Desibour, MD

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

4301057841 Issued in MI

Practice address

100 Michigan St NE
Grand Rapids, MI 49503-2560

Phone

(616) 391-1680

NPI assigned

Jul 16, 2006

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

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

University of Michigan Medical School, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ecs Western Michigan PCGroup PAC ID 8628327384, 202 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Corewell Health Reed City Hospital Hospital, Reed City, MI, CCN 231323
• Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

Merit-based Incentive Payment System (MIPS)

Final score

97.48 of 100Reported as group

Quality

89.26

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Ecs Western Michigan PC

  • Emergency Medicine Physician
  • Grand Rapids, MI
  • NPI 1992281000

  Anesthesiology

  Medicare reassignment Care Compare group NPD
• Rightcare Clinic PC

  • Specialist
  • Grand Rapids, MI
  • NPI 1972372142
  Medicare reassignment NPD
• Visionary Medical Services PC

  • Emergency Medicine Physician
  • Grand Rapids, MI
  • NPI 1538216569

  Anesthesiology

  Medicare reassignment NPD

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

• Pennock Hospital

  • Critical Access Hospital
  • Hastings, MI
  • NPI 1932695525
  Care Compare affiliation
• Reed City Hospital Corporation

  • Critical Access Hospital
  • Reed City, MI
  • NPI 1437259843
  Care Compare affiliation
• Spectrum Health Hospitals

  • General Acute Care Hospital
  • Grand Rapids, MI
  • NPI 1922090554
  Care Compare affiliation

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1891712741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 EMBASSY DR SE STE 400",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462416",
            "telephone_number": "616-975-1845",
            "fax_number": "616-285-0846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-391-1680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESIBOUR",
        "first_name": "CHARLES",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-16",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301057841",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MI",
            "license": "4301057841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "930080726",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deanna M Deschler, MD
• Madysun Marie Desgrange
• Jana Ruth Deshane, BS
• Kandis Koreen Deshaw, LMSW
• Aashish A Deshpande, MD
• Murambya Desire
• Erin Desmet, MSW
• Rebecca Joy Desouza, BEHAVIOR TECHNICIAN
• Heather Faye Despres Cook, PT
• Nancy Louise Despres

• Emergency Medical Services (Emergency Medicine) Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Emergency Medical Services (Emergency Medicine) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2025; 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.