1. Home
  2. Directory
  3. Michigan
  4. Grand Rapids
  5. General Practice
  6. NPI Profile

DR. GARY DAVID POELMAN M.D.
NPI 1336261395
General Practice in Grand Rapids, MI

Active since April 03, 2007PECOS Enrolled
3355 EAGLE PARK DR NE, STE103, GRAND RAPIDS, MI 49525(616) 942-7400 Get Directions Write a Review

NPPES record last updated: September 14, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Gary David Poelman M.d. NPPES

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

DR. GARY DAVID POELMAN M.D. (NPI 1336261395) is an individual general practice provider in Grand Rapids, Michigan, licensed in Michigan (GP043454) and active in the NPI registry since April 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1336261395
Entity TypeIndividualMale
Primary Taxonomy208D00000X
Provider Legal NameDR. GARY DAVID POELMANCredential: M.D.
Location Address3355 EAGLE PARK DR NE, STE103Grand Rapids, MI 49525-7004
Mailing Address3713 Norton Hills RdNorton Shores, MI 49441-4469
Phone(616) 942-7400
Sole ProprietorNo
Enumeration DateApril 3, 2007
Last NPPES UpdateSeptember 14, 2015
✔ NPI 1336261395 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in MI · GP043454
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
Also ListedEmergency Medicine · Emergency Medical ServicesTaxonomy 207PE0004X · License GP043454 (MI)
Also ListedFamily Medicine · Geriatric MedicineTaxonomy 207QG0300X · License GP043454 (MI)
3355 EAGLE PARK DR NE, Grand Rapids, MI 49525
Open in Google Maps ↗

Other Identifiers 7

Medicare PIND16037002
Other0107001012Bcbs
Other40099285Aetna
OtherB43739Priority Health
Other152750Phcs
Medicare UPINB43739
Other117141PCCchmo,ccppo,mercy

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Gary David Poelman 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.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers11 claims11 services$55.22 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 18

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

KATHI RAE LOTTERMAN PA-C
Physician Assistant
3355 EAGLE PARK DR NE, SUITE 103
GRAND RAPIDS, MI 49525
Kent County (616) 942-7400
MARK F GILLETTE PA-C
Physician Assistant
3355 EAGLE PARK DR NE, SUITE 103
GRAND RAPIDS, MI 49525
Kent County (616) 942-7400
MS. MOLLY JO RAAYMAKERS L.L.P.
Psychologist
3355 EAGLE PARK DR NE, STE 107
GRAND RAPIDS, MI 49525
Kent County (616) 940-9870
MICHAEL W BORGELD MD
Internal Medicine
3355 EAGLE PARK DR NE, SUITE 103
GRAND RAPIDS, MI 49525
Kent County (616) 942-7400
MR. DAVID CHARLES SCHROEDER LMSW
Social Worker (Clinical)
3355 EAGLE PARK DR NE, STE 107
GRAND RAPIDS, MI 49525
Kent County (616) 666-9921
KIMBERLY K DECKER PA
Physician Assistant
3355 EAGLE PARK DR NE, SUITE 103
GRAND RAPIDS, MI 49525
Kent County (616) 942-7400
PROFESSIONAL PAIN MANAGEMENT PC
Pain Medicine (Pain Medicine)
3355 EAGLE PARK DR NE, SUITE 106
GRAND RAPIDS, MI 49525
Kent County (616) 808-3500
MS. NATALIE DAWN BEVERSLUIS B.S., M.ED., L.M.T.
Massage Therapist
3355 EAGLE PARK DR NE, 107
GRAND RAPIDS, MI 49525
Kent County (616) 617-3760

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 Gary Poelman's NPI number?

The NPI number for Gary Poelman is 1336261395. It was assigned to this individual provider in the NPPES registry on April 3, 2007.

Where is Gary Poelman located?

Gary Poelman practices at 3355 Eagle Park Dr NE Ste103, Grand Rapids, MI 49525. The listed phone number is (616) 942-7400.

What is Gary Poelman's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Gary Poelman enrolled in Medicare?

Yes. Gary Poelman is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Gary Poelman was last updated on September 14, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.