PEDIATRIC SURGEONS OF WEST MICHIGAN PC
NPI 1477516110
Surgery in Grand Rapids, MI

Q: What is Pediatric Surgeons Of West Michigan PC's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Active since April 11, 2006

330 BARCLAY NE, SUITE 202, GRAND RAPIDS, MI 49503(616) 458-1722(616) 458-0061 Get Directions Write a Review

NPPES record last updated: March 8, 2017. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Pediatric Surgeons Of West Michigan Pc NPPES

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

PEDIATRIC SURGEONS OF WEST MICHIGAN PC (NPI 1477516110) is a healthcare organization registered as a surgery in Grand Rapids, Michigan and active in the NPI registry since April 2006. The organization lists Jennifer L Jamula, Practice Manager, as its authorized official.

NPPES Registry Identity

NPI1477516110

Entity TypeOrganization

Primary Taxonomy208600000X

Legal Business NamePEDIATRIC SURGEONS OF WEST MICHIGAN PC

Location Address330 BARCLAY NE, SUITE 202Grand Rapids, MI 49503

Mailing Address330 Barclay Ne, Suite 202Grand Rapids, MI 49503 · (616) 458-1722 · Fax (616) 458-0061

Phone(616) 458-1722

Fax(616) 458-0061

Organization SubpartNo

Authorized OfficialJennifer L JamulaPractice Manager · (616) 458-1722

Enumeration DateApril 11, 2006

Last NPPES UpdateMarch 8, 2017

✔ NPI 1477516110 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208600000X

Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

330 BARCLAY NE, Grand Rapids, MI 49503

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Other Identifiers 1

Other020D176760Blue Cross Blue Shield

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Pediatric Surgeons Of West Michigan Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 5 clinicians reassign Medicare billing to Pediatric Surgeons Of West Michigan PC, which bills Medicare for the services they deliver. Of these, 5 practice at this address. They are listed nearest first.

Clinicians, nearest first (5)

James Decou, MD

General Surgery

NPI 1326197625

330 BARCLAY AVE NE SUITE 202
Grand Rapids, MI 49503

(616) 458-1722

✔ PECOS✔ Accepts MedicareSame address

Eric Groh, M.D.

General Surgery

NPI 1821359613

330 BARCLAY AVE NE
Grand Rapids, MI 49503

(616) 458-1722

✔ PECOSSame address

Elliot Pennington, MD

General Surgery

NPI 1235365081

330 BARCLAY AVE NE STE 202
Grand Rapids, MI 49503

(616) 443-8007

✔ PECOS✔ Accepts MedicareSame address

Marc Schlatter, MD

General Surgery

NPI 1235288317

330 BARCLAY AVE NE SUITE202
Grand Rapids, MI 49503

(616) 458-1722

✔ PECOSSame address

Daniel Watkins, MD

General Surgery

NPI 1114159415

330 BARCLAY AVE NE SUITE 202
Grand Rapids, MI 49503

(616) 458-1722

✔ PECOS✔ Accepts MedicareSame address

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

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 Pediatric Surgeons Of West Michigan PC's NPI number?

The NPI number for Pediatric Surgeons Of West Michigan PC is 1477516110. It was assigned to this organization in the NPPES registry on April 11, 2006.

Where is Pediatric Surgeons Of West Michigan PC located?

Pediatric Surgeons Of West Michigan PC is located at 330 Barclay NE Suite 202, Grand Rapids, MI 49503. The listed phone number is (616) 458-1722.

What is Pediatric Surgeons Of West Michigan PC's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Pediatric Surgeons Of West Michigan PC enrolled in Medicare?

Yes. Pediatric Surgeons Of West Michigan PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Pediatric Surgeons Of West Michigan PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians, all in General Surgery, reassign their Medicare billing to Pediatric Surgeons Of West Michigan PC. A 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 the clinician's services. Of these, 5 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Pediatric Surgeons Of West Michigan PC accept?

Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Pediatric Surgeons Of West Michigan PC 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 Pediatric Surgeons Of West Michigan PC was last updated on March 8, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.