PHILIP MUELLERLEILE (M.D.) – Pediatric Anesthesiology Physician, NPI 1104204478

PHILIP MUELLERLEILE (M.D.) is a healthcare provider. based in Grand rapids, Michigan. specializing in ANESTHESIOLOGY. They hold the professional credentials M.D.. They hold a License No. 4301501441 (MI). The NPI Number for PHILIP MUELLERLEILE (M.D.) is 1104204478

Main info

Male
11 Years Of Experience
Accepts Medicare Assignment
Name
PHILIP MUELLERLEILE (M.D.)
NPI
1104204478
Phone
(616) 685-5000
Address
200 Jefferson Ave SE
Enumeration Date
7 May 2015
Last Update Date
17 December 2025

Doctor Profile

Medical School Name
MICHIGAN STATE UNIVERSITY COLLEGE OF HUMAN MEDICINE
Secondary Phone
7342632400
Graduation Year
2015 (11 years ago)
PAC ID
2567764020
Group Practice PAC ID
4981500436
Professional Enrollment ID
I20200731001852
Address ID
MI495034502GR200XXSEXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness85
Years active:11State licenses:1Digital endpointsOther names

1,714 ANESTHESIOLOGY in MI

Provider Addresses for PHILIP MUELLERLEILE (M.D.)

  • 200 Jefferson Ave SE

    Grand Rapids, MI 495034502

    Phone: (616) 685-5000

    Type: Location

  • 1500 E Sherman Blvd

    Muskegon, MI 494441849

    Phone: (231) 672-2000

    Type: Location

  • 3333 EVERGREEN DR NE

    GRAND RAPIDS, MI 495259493

    Phone: (616) 638-0832

    Type: Mailing

  • 100 MICHIGAN ST NE

    GRAND RAPIDS, MI 495032560

    Phone: (616) 284-3133

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-07-31

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20200731001852IAnesthesiologyMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49503)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4981500436View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)MI
Certified Registered Nurse Anesthetist (Crna)MI
Certified Registered Nurse Anesthetist (Crna)PA
-MI
A N E S T H E S I O L O G YWI
A N E S T H E S I O L O G YMI
Certified Registered Nurse Anesthetist (Crna)MI
Certified Registered Nurse Anesthetist (Crna)MI
Certified Registered Nurse Anesthetist (Crna)MI
-MI

Reviews

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Frequently asked questions

How do payers reference PHILIP MUELLERLEILE (M.D.)?
For PHILIP MUELLERLEILE (M.D.), use NPI 1104204478 as the unique 10-digit identifier.
Would PHILIP MUELLERLEILE (M.D.) appear as active to a payer?
You can treat PHILIP MUELLERLEILE (M.D.) as active for directory purposes; confirm clinical privileges separately.
What kind of doctor is PHILIP MUELLERLEILE (M.D.)?
PHILIP MUELLERLEILE (M.D.) is associated with Pediatric Anesthesiology Physician in the directory — Clinical services aligned with this taxonomy classification.
Where in Michigan is PHILIP MUELLERLEILE (M.D.) registered?
Use Grand Rapids, Michigan as the headline location for PHILIP MUELLERLEILE (M.D.) here.
When was this NPI issued?
Enumeration for PHILIP MUELLERLEILE (M.D.) is noted as May 7, 2015 where the registry provides it.

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