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DR. TAMMY LYNN PROVATAS M.D.
NPI 1275795239
Emergency Medicine in Grand Rapids, MI

Active since June 30, 2008PECOS Enrolled
100 MICHIGAN ST NE # MC-49, GRAND RAPIDS, MI 49503(616) 391-8879 Get Directions Write a Review

NPPES record last updated: June 30, 2008. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Tammy Lynn Provatas M.d. NPPES

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

DR. TAMMY LYNN PROVATAS M.D. (NPI 1275795239) is an individual emergency medicine provider in Grand Rapids, Michigan, licensed in Michigan (4301092916) and active in the NPI registry since June 2008. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1275795239
Entity TypeIndividualFemale
Primary Taxonomy207P00000X
Provider Legal NameDR. TAMMY LYNN PROVATASCredential: M.D.
Location Address100 MICHIGAN ST NE # MC-49Grand Rapids, MI 49503-2560
Mailing Address1699 Sycamore DrMuskegon, MI 49445-3400 · (231) 740-3750
Phone(616) 391-8879
Sole ProprietorNo
Enumeration DateJune 30, 2008
✔ NPI 1275795239 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License✔ Licensed in MI · 4301092916
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
100 MICHIGAN ST NE # MC-49, Grand Rapids, MI 49503
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Tammy Lynn Provatas M.d. 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.

Medicare Billing Reassignment

Medicare enrollment records show Tammy Provatas reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Lake Michigan Emergency Specialists, PLLC
34 mi
Emergency Medicine
1700 CLINTON ST, EMERGENCY DEPARTMENT
Muskegon, MI 49442
  • Reassigned Medicare billing, Michigan enrollment
  • 83 clinicians in this Medicare group
NPI 1124574520 (231) 728-4601

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician 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.

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
$96.44 typical visit price
range $17.09 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
Most-billed visit code 99214
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

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

DR. KARA BETH CARDENAS M.D.
Emergency Medicine
100 MICHIGAN ST NE # MC-49
GRAND RAPIDS, MI 49503
Kent County (616) 391-8879

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 Tammy Provatas's NPI number?

The NPI number for Tammy Provatas is 1275795239. It was assigned to this individual provider in the NPPES registry on June 30, 2008.

Where is Tammy Provatas located?

Tammy Provatas practices at 100 Michigan St NE # Mc-49, Grand Rapids, MI 49503. The listed phone number is (616) 391-8879.

What is Tammy Provatas's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Tammy Provatas enrolled in Medicare?

Yes. Tammy Provatas is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Tammy Provatas's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Tammy Provatas reassigns Medicare benefits to Lake Michigan Emergency Specialists, PLLC (Muskegon, MI). The 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 Tammy Provatas's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Tammy Provatas was last updated on June 30, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years 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.