DR. TIMOTHY RUSSEL JELSEMA (MD) – Sports Medicine (Family Medicine) Physician, NPI 1871944397
Sports Medicine (Family Medicine) Physician
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
4,418 FAMILY PRACTICE in MI
Provider Addresses for DR. TIMOTHY RUSSEL JELSEMA (MD)
100 MICHIGAN ST NE # MC845
GRAND RAPIDS, MI 495032560
Phone:
Type: Mailing
705 OAK ST UNIT 11
BIG RAPIDS, MI 493073108
Phone: (231) 592-1002
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $18.
Total Amount is formed as General ($18) + Research ($0) + Ownership ($0) = $18.
Last reported payment date: 2023-03-18 • Largest payer in this snapshot: Orthofix Medical, Inc. ($18).
Total Amount
$18
General + Research + Ownership
Payments
1
Total payment records
General Amount
$18
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-03-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Orthofix Medical, Inc. | $18 |
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: 2020-05-04
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 |
|---|---|---|---|---|
| I20200504001926 | I | Family Practice | 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 |
|---|---|---|---|---|
| J1030 | Injection, methylprednisolone acetate, 40 mg | 163 | 94 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 96 | 71 | $0 |
| 20611 | Aspiration and/or injection of fluid large joint using ultrasound guidance | 84 | 56 | $0 |
| 20610 | Aspiration and/or injection of fluid from large joint | 75 | 46 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 64 | 64 | $0 |
Insurance plans in this area (ZIP 49503)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | MI | |
| Physician Assistant | OR | |
| Physician Assistant | MI | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MI | |
| Physician Assistant | MI | |
| Family Practice | MI | |
| Physician Assistant | MI | |
| Family Practice | MI | |
| Physician Assistant | MI | |
| Physician Assistant | MI |
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