DAVID TETSUJI ISHIYAMA (M.D.) – Emergency Medicine Physician, NPI 1407177884
Emergency Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,157 EMERGENCY MEDICINE in MI
Provider Addresses for DAVID TETSUJI ISHIYAMA (M.D.)
44650 DANBURY RD
CANTON, MI 481881050
Phone:
Type: Mailing
1000 MONROE AVE NW
GRMEP
GRAND RAPIDS, MI 495031455
Phone: (616) 391-8879
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: 2013-07-30
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20130730000120 | I | Emergency Medicine | MI | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99285 | Emergency department visit with high level of medical decision making | 364 | 346 | $0 |
| 93042 | Electrocardiogram (ecg) 1 to 3 leads with review by physician only | 117 | 114 | $0 |
| 99284 | Emergency department visit with moderate level of medical decision making | 78 | 77 | $0 |
| 99291 | Critical care, first 30-74 minutes | 66 | 66 | $0 |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 23 | 23 | $0 |
Insurance plans in this area (ZIP 48188)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Emergency Medicine | MI | |
| Emergency Medicine | MI | |
| Emergency Medicine | MI | |
| Emergency Medicine | MI | |
| Emergency Medicine | MI | |
| Emergency Medicine | MI | |
| Emergency Medicine | MI | |
| Nurse Practitioner | MI | |
| Emergency Medicine | MI | |
| Physician Assistant | MI |
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