Active NPI
David Edward Tiesma, M.D.
- Internal Medicine Physician
- Grand Rapids, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 4301106108
- Practice address
- 275 Michigan St NE Ste 8100
Grand Rapids, MI 49503-2531 - Phone
- (616) 267-0800
- NPI assigned
- Jun 20, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 4301106108 | MI | |
| Internal Medicine Physician | 207R00000X | 4301106108 | MI | Primary |
Addresses
Primary practice location
275 Michigan St NE Ste 8100
Grand Rapids, MI 49503-2531
Mailing address
100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | dtiesma103652@epic00.shdirect.org | ||
| FHIR URL | https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/ |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Wayne State University School of Medicine, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 Michigan Ave NE
Grand Rapids, MI 49503-2560
Phone (616) 391-1774
100 Michigan St Northeast
Corewell Health Grand Rapids Hospit
Grand Rapids, MI 49503-2560
Phone (616) 391-1774
275 Michigan St NE
Grand Rapids, MI 49503-2531
Phone (616) 391-3777
Hospital & facility affiliations
- Spectrum Health
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301106108 | MI | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spectrum Health Hospitals | Internal Medicine | Current | Accepting new patients |
| Brookville Pediatric & Internal Medicine, PC | Internal Medicine | Current | Accepting new patients |
| Spectrum Health Hospitals | Current | Accepting new patients |
Locations
100 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1680
100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242
275 Michigan St NE
Ste 8100
Grand Rapids, MI 49503
Phone (616) 267-0800
8485 Algoma Ave NE
Rockford, MI 49341
Phone (616) 863-6220
1200 56th St SW
Wyoming, MI 49509
Phone (616) 243-5707
Organizations & group practices 3
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.
-
- Pediatrics Physician
- Wyoming, MI
- NPI 1346200847
Internal Medicine
-
- General Acute Care Hospital
- Grand Rapids, MI
- NPI 1922090554
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Hastings, MI
- NPI 1932695525
-
- General Acute Care Hospital
- Grand Rapids, MI
- NPI 1922090554
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1403222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752192000000",
"number": "1922412600",
"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": "275 MICHIGAN ST NE STE 8100",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495032531",
"telephone_number": "616-267-0800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIESMA",
"first_name": "DAVID",
"middle_name": "EDWARD",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-20",
"last_updated": "2025-07-11",
"certification_date": "2025-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MI",
"license": "4301106108",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MI",
"license": "4301106108",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "dtiesma103652@epic00.shdirect.org",
"affiliation": "N",
"address_1": "275 Michigan St NE Ste 8100",
"city": "Grand Rapids",
"state": "MI",
"country_code": "US",
"postal_code": "495032531",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/",
"affiliation": "N",
"address_1": "275 Michigan St NE Ste 8100",
"city": "Grand Rapids",
"state": "MI",
"country_code": "US",
"postal_code": "495032531",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.