Lissette Jimenez, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301502123 Issued in MI

Practice address

100 Michigan St NE
Grand Rapids, MI 49503-2560

Phone

(616) 391-3139

NPI assigned

Apr 3, 2017

Last updated

Apr 11, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

HospitalistAlso: Internal Medicine

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Spectrum Health Primary Care PartnersGroup PAC ID 4587568647, 2,283 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Corewell Health Hospice & Palliative Care - West Michigan Hospice, Grand Rapids, MI, CCN 231544
• Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ljimenez441541@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Spectrum Health Primary Care Partners

  dba Corewell Health Medical Group West

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1235188673
  Medicare reassignment Care Compare group NPD
• Sparrow Clinton Hospital

  dba SMG St Johns

  • Multi-Specialty Clinic/Center
  • Saint Johns, MI
  • NPI 1306893078
  Medicare reassignment NPD
• Sparrow Eaton Hospital

  dba University of Michigan Health-Sparrow Charlotte Orthopedics

  • Orthopaedic Surgery Physician
  • Charlotte, MI
  • NPI 1043419427
  Medicare reassignment NPD
• Sparrow Ionia Hospital

  dba University of Michigan Health-Sparrow Ionia

  • Critical Access Hospital
  • Ionia, MI
  • NPI 1700820065
  Medicare reassignment NPD
• Vituity - Michigan Hospitalists PC

  • Hospitalist Physician
  • Lansing, MI
  • NPI 1487278156

  Internal Medicine

  Medicare reassignment NPD
• Sparrow Specialty Hospital

  dba University of Michigan Health-Sparrow Specialty Hospital

  • Long Term Care Hospital
  • Lansing, MI
  • NPI 1437655842
  Medicare reassignment
• Sparrow Clinton Hospital

  dba University of Michigan Health-Sparrow Clinton

  • Critical Access Hospital
  • Saint Johns, MI
  • NPI 1093809824
  NPD
• Sparrow Eaton Hospital

  dba East Lansing Public Schools Health Center

  • School Nurse Practitioner
  • East Lansing, MI
  • NPI 1063227486
  NPD
• Sparrow Eaton Hospital

  • Hospitalist Physician
  • Charlotte, MI
  • NPI 1235420092
  NPD
• Sparrow Ionia Hospital

  dba Sparrow Medical Group Ionia

  • Family Medicine Physician
  • Ionia, MI
  • NPI 1033271143
  NPD
• Sparrow Ionia Hospital

  dba Sparrow Ionia Hospital Physicians

  • Emergency Medicine Physician
  • Ionia, MI
  • NPI 1588747075

  Internal Medicine

  NPD
• Spectrum Health Primary Care Partners

  dba Corewell Health Medical Group West

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1689499667
  NPD

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

• Pennock Hospital

  dba Corewell Health Pennock Hospital

  • Critical Access Hospital
  • Hastings, MI
  • NPI 1932695525
  Care Compare affiliation
• Spectrum Health Continuing Care

  dba Corewell Health Hospice & Palliative Care West Michigan

  • Community Based Hospice Care Agency
  • Grand Rapids, MI
  • NPI 1225012099
  Care Compare affiliation
• Spectrum Health Hospitals

  dba Corewell Health Grand Rapids Hospital

  • 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": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1932631322",
    "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": "100 MICHIGAN ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-391-3139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "LISSETTE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-03",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301502123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Briana Elise Jibson, LPC
• Jill Dubridge Counseling
• Andrea Jimenez Gutierrez, MD
• Yarixa Jimenez-Colon
• Esther Jimenez, D.D.S
• Maria Elena Jimenez
• Priscilla Jimenez, PMHNP-BC
• Raelynn Jimenez
• Reyna Doris Mae Jimenez
• Victor M Jimenez, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2022; 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.