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JEREMY DAVID MORMOL MD
NPI 1174142285
Radiology - Diagnostic Radiology in Grand Rapids, MI

Active since April 09, 2020PECOS Enrolled
3246 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525(616) 459-7225 Get Directions Write a Review

NPPES record last updated: June 4, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 4, 2026, May 20, 2025, Jun 24, 2024 and 2 more (5 updates tracked since 2020).

About Jeremy David Mormol Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JEREMY DAVID MORMOL MD (NPI 1174142285) is an individual diagnostic radiology provider in Grand Rapids, Michigan, licensed in Michigan (4351046796) and active in the NPI registry since April 2020. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1174142285
Entity TypeIndividualMale
Primary Taxonomy2085R0202X
Provider Legal NameJEREMY DAVID MORMOLCredential: MD
Location Address3246 N EVERGREEN DR NEGrand Rapids, MI 49525
Mailing Address3246 N Evergreen Dr NeGrand Rapids, MI 49525
Phone(616) 459-7225
Sole ProprietorNo
Enumeration DateApril 9, 2020
Last NPPES UpdateJune 4, 20265 updates tracked since enumeration
NPPES CertifiedJune 4, 2026
✔ NPI 1174142285 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
License✔ Licensed in MI · 4351046796
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
3246 N EVERGREEN DR NE, Grand Rapids, MI 49525
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jeremy David Mormol Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49525 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.74 typical visit price
range $54.34 – $166.68
Typical copayment $21.18 (range $13.58 – $41.67)
Most-billed visit code 99203
Established Patient
$68.07 typical visit price
range $17.09 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JOSEPH MATTHEW BROWN MD
Radiology (Vascular & Interventional Radiology)
3246 N EVERGREEN DR NE
GRAND RAPIDS, MI 49525
Kent County (616) 459-7225
DR. COLLIN MARK SCHULTZ DO
Radiology (Vascular & Interventional Radiology)
3246 N EVERGREEN DR NE
GRAND RAPIDS, MI 49525
Kent County (616) 459-7225

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 Jeremy Mormol's NPI number?

The NPI number for Jeremy Mormol is 1174142285. It was assigned to this individual provider in the NPPES registry on April 9, 2020.

Where is Jeremy Mormol located?

Jeremy Mormol practices at 3246 N Evergreen Dr NE, Grand Rapids, MI 49525. The listed phone number is (616) 459-7225.

What is Jeremy Mormol's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Is Jeremy Mormol enrolled in Medicare?

Yes. Jeremy Mormol is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jeremy Mormol was last updated on June 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.