GREGORY S MERVENNE (MD) – Hospice and Palliative Medicine (Emergency Medicine) Physician, NPI 1215955752

GREGORY S MERVENNE (MD) is a healthcare provider. based in Grand rapids, Michigan. specializing in EMERGENCY MEDICINE, HOSPICE/PALLIATIVE CARE, INTERNAL MEDICINE, PEDIATRIC MEDICINE. They hold the professional credentials MD. They hold a License No. 4301060010 (MI). The NPI Number for GREGORY S MERVENNE (MD) is 1215955752

Main info

Male
34 Years Of Experience
Accepts Medicare Assignment
Name
GREGORY S MERVENNE (MD)
NPI
1215955752
Phone
(616) 391-9945
Address
145 MICHIGAN ST NE
Enumeration Date
17 July 2006
Last Update Date
2 April 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9897312100
Graduation Year
1992 (34 years ago)
PAC ID
3173522398
Group Practice PAC ID
6800241050
Professional Enrollment ID
I20070409000266
Address ID
MI497351592GA825XXAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

3,157 EMERGENCY MEDICINE in MI

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Provider Addresses for GREGORY S MERVENNE (MD)

  • 145, Michigan Street Northeast, Grand Rapids, Kent County, Michigan, 49503, United States

    SUITE 4400

    GRAND RAPIDS, MI 495032562

    Phone: (616) 391-9945

    Fax: (616) 486-6346

    Type: Location

  • Spectrum Health Butterworth Hospital, 100, Michigan Street Northeast, Grand Rapids, Kent County, Michigan, 49503, United States

    MC 845

    GRAND RAPIDS, MI 495032560

    Phone:

    Type: Mailing

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: 2007-04-09

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
I20070409000266IEmergency MedicineMITBD

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: 6800241050View full group profile
NameSpecialtyState
Emergency MedicineMI
Emergency MedicineMI
Nurse PractitionerMI
Emergency MedicineMI
Emergency MedicineIL
Emergency MedicineRI
Emergency MedicineMI
Emergency MedicineMI
Nurse PractitionerMI
Nurse PractitionerSD

Reviews

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Frequently asked questions

What unique ID ties claims to GREGORY S MERVENNE (MD)?
NPI 1215955752 is assigned to GREGORY S MERVENNE (MD) under the national enumeration system.
Is GREGORY S MERVENNE (MD)'s NPI currently valid?
The extract we use shows GREGORY S MERVENNE (MD) as active.
What kind of provider is GREGORY S MERVENNE (MD)?
The page reflects Hospice and Palliative Medicine (Emergency Medicine) Physician for GREGORY S MERVENNE (MD). Clinical services aligned with this taxonomy classification.
What location metadata exists for GREGORY S MERVENNE (MD)?
The page summarizes Grand Rapids, Michigan for GREGORY S MERVENNE (MD); expand the address list for detail.
Is GREGORY S MERVENNE (MD) a real provider?
This page reflects official NPPES data for NPI 1215955752. Always confirm identity and privileges with the practice and licensing boards.

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