JUSTIN R STALEY DO
NPI 1164044830
Emergency Medicine in Grand Rapids, MI
About Justin R Staley Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JUSTIN R STALEY DO (NPI 1164044830) is an individual emergency medicine provider in Grand Rapids, Michigan, licensed in Michigan (5101026712) and active in the NPI registry since May 2020. He is enrolled in Medicare PECOS, is affiliated with Mercy Health Saint Mary's, and maintains a secondary practice location in Auburn.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Justin R Staley Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
4Medicare enrollment records show Justin Staley reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Grand Rapids, MI 49503
- Reassigned Medicare billing, Michigan enrollment
- 55 clinicians in this Medicare group
Muskegon, MI 49444
- Reassigned Medicare billing, Michigan enrollment
- 61 clinicians in this Medicare group
Muskegon, MI 49442
- Reassigned Medicare billing, Michigan enrollment
- 83 clinicians in this Medicare group
Fort Wayne, IN 46805
- Reassigned Medicare billing, Indiana enrollment
- 162 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 4
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Mercy Health Saint Mary's
Acute Care Hospitals · Grand Rapids, MIPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 49503 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
GRAND RAPIDS, MI 49503
GRAND RAPIDS, MI 49503
GRAND RAPIDS, MI 49503
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Justin Staley's NPI number?
The NPI number for Justin Staley is 1164044830. It was assigned to this individual provider in the NPPES registry on May 15, 2020.
Where is Justin Staley located?
Justin Staley practices at 200 Jefferson Ave SE, Grand Rapids, MI 49503. The listed phone number is (616) 685-5000.
What is Justin Staley's specialty?
The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.
Is Justin Staley enrolled in Medicare?
Yes. Justin Staley is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Justin Staley's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Justin Staley reassigns Medicare benefits to 4 organizations: Grand River Emergency Medical Group Plc (Grand Rapids, MI), Lake Michigan Observation Services PLLC (Muskegon, MI), Lake Michigan Emergency Specialists, PLLC (Muskegon, MI) and Professional Emergency Physicians PC (Fort Wayne, IN). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Justin Staley's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Justin Staley accept?
Health plans from Oscar Insurance Company list Justin Staley as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Justin Staley affiliated with any hospitals?
According to CMS data, Justin Staley is affiliated with Mercy Health Saint Mary's.
When was this NPI record last updated?
The NPPES record for Justin Staley was last updated on September 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 47 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Justin R Staley, DO · NPI 1164044830
Emergency Medicine physician in Grand Rapids, Michigan. Individual provider, active in the CMS NPPES registry since May 15, 2020.
## Identity
- **NPI:** 1164044830 (Entity type: Individual)
- **Enumerated:** May 15, 2020
- **Primary specialty:** Emergency Medicine · taxonomy 207P00000X
- **State license:** 5101026712 (Michigan)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 200 JEFFERSON AVE SE, Grand Rapids, MI 49503-4502
- **Phone:** (616) 685-5000
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Grand River Emergency Medical Group Plc (NPI 1114929353, Grand Rapids, MI); Lake Michigan Observation Services PLLC (NPI 1518626043, Muskegon, MI); Lake Michigan Emergency Specialists, PLLC (NPI 1124574520, Muskegon, MI); Professional Emergency Physicians PC (NPI 1144215096, Fort Wayne, IN) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2020
## Record status
- **NPPES last updated:** September 9, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1164044830) · Data from the CMS NPPES public registry.