MR. THOMAS RAYMOND ULRICH (PA-C) – Physician Assistant, NPI 1801803275
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MR. THOMAS RAYMOND ULRICH (PA-C)
61, Commerce Avenue Southwest, Grand Rapids, Kent County, Michigan, 49503, United States
GRAND RAPIDS, MI 495034124
Phone: (616) 940-0660
Fax: (616) 940-1965
Type: Mailing
5555 GLENWOOD HILLS PKWY SE STE 2
GRAND RAPIDS, MI 495122091
Phone: (616) 940-2662
Fax: (616) 940-1965
Type: Mailing
3950 HOLLYWOOD RD STE 260
SAINT JOSEPH, MI 490859151
Phone: (269) 429-3865
Fax: (269) 428-2320
Type: Location
3950, Hollywood Road, Royalton Township, Berrien County, Michigan, 49085, United States
SAINT JOSEPH, MI 490859151
Phone: (269) 429-3865
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $100.
Total Amount is formed as General ($100) + Research ($0) + Ownership ($0) = $100.
Last reported payment date: 2024-09-12 • Largest payer in this snapshot: Abbott Laboratories ($74).
Total Amount
$100
General + Research + Ownership
Payments
4
Total payment records
General Amount
$100
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Abbott Laboratories | $74 |
| PAINTEQ LLC | $27 |
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: 2006-11-02
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 |
|---|---|---|---|---|
| I20061102000375 | I | Physician Assistant | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 488 | 208 | $0 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 335 | 32 | $0 |
| J1885 | Injection, ketorolac tromethamine, per 15 mg | 323 | 96 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 305 | 175 | $0 |
| 20552 | Injection of trigger points, 1-2 muscles | 101 | 70 | $0 |
Insurance plans in this area (ZIP 49503)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | MI | 20610 | Aspiration and/or injection of large joint or joint capsule | 135 | 80 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | MI | |
| - | MI | |
| Pain Management, Anesthesiology, Interventional Pain Management | MI | |
| Physician Assistant | MI | |
| Pain Management | MI | |
| Pain Management, Anesthesiology | MI | |
| Nurse Practitioner | MI | |
| Nurse Practitioner | MI | |
| Physical Therapist In Private Practice | MI | |
| Physician Assistant | MI |
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