DAVID TETSUJI ISHIYAMA M.D.
NPI 1407177884
Emergency Medicine in Grand Rapids, MI
About David Tetsuji Ishiyama M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DAVID TETSUJI ISHIYAMA M.D. (NPI 1407177884) is an individual emergency medicine provider in Grand Rapids, Michigan, licensed in Michigan (4301096372) and active in the NPI registry since June 2010. He is enrolled in Medicare PECOS, is affiliated with Henry Ford Allegiance Health, and is a graduate of Michigan State University College Of Human Medicine (2010).
NPPES Registry Identity
Specialties & Licenses
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
David Tetsuji Ishiyama M.d. 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 David Ishiyama reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Jackson, MI 49201
- Reassigned Medicare billing, Michigan enrollment
- 48 clinicians in this Medicare group
Jackson, MI 49201
- Reassigned Medicare billing, Michigan enrollment
- Medicare enrollment name: W.A. Foote Memorial Hospital
- 11 clinicians in this Medicare group
Southfield, MI 48075
- Reassigned Medicare billing, Michigan enrollment
- Medicare enrollment name: Independent Emergency Physicians PC
- 273 clinicians in this Medicare group
Southfield, MI 48075
- Reassigned Medicare billing, Michigan enrollment
- 239 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 7
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.
Henry Ford Allegiance Health
Acute Care Hospitals · Jackson, 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
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 David Ishiyama's NPI number?
The NPI number for David Ishiyama is 1407177884. It was assigned to this individual provider in the NPPES registry on June 19, 2010.
Where is David Ishiyama located?
David Ishiyama practices at 1000 Monroe Ave NW Grmep, Grand Rapids, MI 49503. The listed phone number is (616) 391-8879.
What is David Ishiyama's specialty?
The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.
Is David Ishiyama enrolled in Medicare?
Yes. David Ishiyama 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 David Ishiyama's services?
According to the CMS Revalidation Reassignment List (October 2026 release), David Ishiyama reassigns Medicare benefits to 4 organizations: Iep Observation Medicine - Jackson PLLC (Jackson, MI), Wa Foote Memorial Hospital, Inc (Jackson, MI), Independent Emergency Physicians, P.C. (Southfield, MI) and Independent Observation Physicians PLLC (Southfield, 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 David Ishiyama's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does David Ishiyama accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list David Ishiyama 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 David Ishiyama affiliated with any hospitals?
According to CMS data, David Ishiyama is affiliated with Henry Ford Allegiance Health.
When was this NPI record last updated?
The NPPES record for David Ishiyama was last updated on May 31, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.
# David Tetsuji Ishiyama, M.D. · NPI 1407177884
Emergency Medicine physician in Grand Rapids, Michigan. Individual provider, active in the CMS NPPES registry since June 19, 2010.
## Identity
- **NPI:** 1407177884 (Entity type: Individual)
- **Enumerated:** June 19, 2010
- **Primary specialty:** Emergency Medicine · taxonomy 207P00000X
- **State license:** 4301096372 (Michigan)
- **Sole proprietor:** No
## Practice location
- **Address:** 1000 MONROE AVE NW, GRMEP, Grand Rapids, MI 49503-1455
- **Phone:** (616) 391-8879
## 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): Iep Observation Medicine - Jackson PLLC (NPI 1982478251, Jackson, MI); Wa Foote Memorial Hospital, Inc (NPI 1265487722, Jackson, MI); Independent Emergency Physicians, P.C. (NPI 1780791343, Southfield, MI); Independent Observation Physicians PLLC (NPI 1700119500, Southfield, MI) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Michigan State University College Of Human Medicine, class of 2010
## Record status
- **NPPES last updated:** May 31, 2013
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Source: [NPI Profile](https://npiprofile.com/npi/1407177884) · Data from the CMS NPPES public registry.