LIFELINE INTERVENTIONAL THERAPEUTICS, PLLC
NPI 1912726811
Psychiatry & Neurology - Psychiatry in Grand Rapids, MI

Q: What is Lifeline Interventional Therapeutics, PLLC's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Active since October 08, 2024

1179 E PARIS AVE SE STE 100, GRAND RAPIDS, MI 49546(616) 400-5433(616) 360-2034 Get Directions Write a Review

NPPES record last updated: December 6, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 6, 2024, Oct 8, 2024 (2 updates tracked since 2024).

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About Lifeline Interventional Therapeutics, Pllc NPPES

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

LIFELINE INTERVENTIONAL THERAPEUTICS, PLLC (NPI 1912726811) is a healthcare organization registered as a psychiatry in Grand Rapids, Michigan and active in the NPI registry since October 2024. The organization lists William Paul Vanlonkhuyzen, Partner/physician Assistant, as its authorized official.

NPPES Registry Identity

NPI1912726811

Entity TypeOrganization

Primary Taxonomy2084P0800X

Legal Business NameLIFELINE INTERVENTIONAL THERAPEUTICS, PLLC

Location Address1179 E PARIS AVE SE STE 100Grand Rapids, MI 49546-3682

Mailing Address1179 E Paris Ave Se Ste 100Grand Rapids, MI 49546-3682 · (616) 400-5433 · Fax (616) 360-2034

Phone(616) 400-5433

Fax(616) 360-2034

Organization SubpartNo

Authorized OfficialWilliam Paul VanlonkhuyzenPartner/physician Assistant · (616) 400-5433

Enumeration DateOctober 8, 2024

Last NPPES UpdateDecember 6, 20242 updates tracked since enumeration

NPPES CertifiedDecember 6, 2024

✔ NPI 1912726811 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0800X

Definition

A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.

Also ListedPsychiatry & Neurology · Addiction MedicineTaxonomy 2084A0401X

Also ListedPsychiatry & Neurology · Pain MedicineTaxonomy 2084P2900X

Also ListedPhysician AssistantTaxonomy 363A00000X

1179 E PARIS AVE SE STE 100, Grand Rapids, MI 49546

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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)

Lifeline Interventional Therapeutics, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 2 clinicians reassign Medicare billing to Lifeline Interventional Therapeutics, PLLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Gilbert Masterson, MD

Psychiatry

NPI 1497740930

1179 EAST PARIS AVE SE STE 100
Grand Rapids, MI 49546

(616) 690-2690

✔ PECOS✔ Accepts MedicareSame address

Julie Wilson, D.O.

Addiction Medicine

NPI 1093934267

1179 E PARIS AVE SE STE 100
Grand Rapids, MI 49546

(616) 400-5433

✔ PECOSSame 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 Lifeline Interventional Therapeutics, PLLC's NPI number?

The NPI number for Lifeline Interventional Therapeutics, PLLC is 1912726811. It was assigned to this organization in the NPPES registry on October 8, 2024.

Where is Lifeline Interventional Therapeutics, PLLC located?

Lifeline Interventional Therapeutics, PLLC is located at 1179 E Paris Ave SE Ste 100, Grand Rapids, MI 49546. The listed phone number is (616) 400-5433.

What is Lifeline Interventional Therapeutics, PLLC's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Lifeline Interventional Therapeutics, PLLC enrolled in Medicare?

Yes. Lifeline Interventional Therapeutics, PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Lifeline Interventional Therapeutics, PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Lifeline Interventional Therapeutics, PLLC, in Addiction Medicine and Psychiatry. 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, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Lifeline Interventional Therapeutics, PLLC accept?

Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Lifeline Interventional Therapeutics, PLLC 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 Lifeline Interventional Therapeutics, PLLC was last updated on December 6, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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.