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MARIE TYSMAN MD
NPI 1396326286
Pediatrics in Grand Rapids, MI

Active since April 21, 2021PECOS Enrolled
275 MICHIGAN ST NE, GRAND RAPIDS, MI 49503(616) 391-8810(616) 391-8897 Get Directions Write a Review

NPPES record last updated: January 22, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 1, 2024, May 13, 2022, Apr 21, 2021 (3 updates tracked since 2021).

About Marie Tysman Md NPPES

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

MARIE TYSMAN MD (NPI 1396326286) is an individual pediatrics provider in Grand Rapids, Michigan, licensed in Michigan (4351048201) and active in the NPI registry since April 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1396326286
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameMARIE TYSMANCredential: MD
Location Address275 MICHIGAN ST NEGrand Rapids, MI 49503-2531
Mailing Address100 Michigan St Ne # Mc845Grand Rapids, MI 49503-2560
Phone(616) 391-8810
Fax(616) 391-8897
Sole ProprietorNo
Enumeration DateApril 21, 2021
Last NPPES UpdateJanuary 22, 20253 updates tracked since enumeration
NPPES CertifiedJanuary 22, 2025
✔ NPI 1396326286 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in MI · 4351048201
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
275 MICHIGAN ST NE, Grand Rapids, MI 49503
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Priority Health.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Marie Tysman 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.

Medicare Billing Reassignments

2

Medicare enrollment records show Marie Tysman reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Spectrum Health Primary Care Partners
0.2 mi
Internal Medicine
100 MICHIGAN ST NE
Grand Rapids, MI 49503
  • Reassigned Medicare billing, Michigan enrollment
  • 2,446 clinicians in this Medicare group
NPI 1689499667 (616) 486-6790
Spectrum Health Hospitals
0.2 mi
Hospitalist
100 MICHIGAN ST NE, MC-907
Grand Rapids, MI 49503
  • Reassigned Medicare billing, Michigan enrollment
  • 405 clinicians in this Medicare group
NPI 1558407189 (616) 774-7377

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 20

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

PHILLIP RICHTER PARAS M.D.
Pediatrics
275 MICHIGAN ST NE
GRAND RAPIDS, MI 49503
Kent County (616) 391-8810
MR. ETHAN J LACOURT PA-C
Physician Assistant
275 MICHIGAN ST NE
GRAND RAPIDS, MI 49503
Kent County (616) 267-7900
CAROLINE BUCKLEY MD
Pediatrics
275 MICHIGAN ST NE
GRAND RAPIDS, MI 49503
Kent County (616) 391-8810
DR. ABEBA M BERHANE MD
Pediatrics
275 MICHIGAN ST NE
GRAND RAPIDS, MI 49503
Kent County (616) 391-8810
MAKAYLA DENAE OTTEMAN PA-C
Physician Assistant
275 MICHIGAN ST NE
GRAND RAPIDS, MI 49503
Kent County (616) 267-7900
HIEN LUU PSYD
Clinical Neuropsychologist
275 MICHIGAN ST NE
GRAND RAPIDS, MI 49503
Kent County (616) 267-7401
HOPE ANN VIVIAN NP
Nurse Practitioner
275 MICHIGAN ST NE
GRAND RAPIDS, MI 49503
Kent County (616) 391-2802
LAURA CLAIRE GOODWIN AGPCNP-BC
Nurse Practitioner (Gerontology)
275 MICHIGAN ST NE
GRAND RAPIDS, MI 49503
Kent County (616) 267-7900

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 Marie Tysman's NPI number?

The NPI number for Marie Tysman is 1396326286. It was assigned to this individual provider in the NPPES registry on April 21, 2021.

Where is Marie Tysman located?

Marie Tysman practices at 275 Michigan St NE, Grand Rapids, MI 49503. The listed phone number is (616) 391-8810.

What is Marie Tysman's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Marie Tysman enrolled in Medicare?

Yes. Marie Tysman is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Marie Tysman's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Marie Tysman reassigns Medicare benefits to 2 organizations: Spectrum Health Primary Care Partners (Grand Rapids, MI) and Spectrum Health Hospitals (Grand Rapids, MI). 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 Marie Tysman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Marie Tysman accept?

Health plans from Priority Health list Marie Tysman 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.

When was this NPI record last updated?

The NPPES record for Marie Tysman was last updated on January 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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.