Justin R Staley, DO - Medicare Emergency Medicine in Grand Rapids, MI

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Justin R Staley, DO is a medicare enrolled "Emergency Medicine" physician in Grand Rapids, Michigan. He went to Marian University College Of Osteopathic Medicine and graduated in 2020 and has 6 years of diverse experience with area of expertise as Emergency Medicine. He is a member of the group practice Grand River Emergency Medical Group Plc and his current practice location is 200 Jefferson Ave Se, Grand Rapids, Michigan. You can reach out to his office (for appointments etc.) via phone at (616) 685-5000.

Justin R Staley is licensed to practice in Michigan (license number 5101026712) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1164044830.

Contact Information

Justin R Staley, DO
200 Jefferson Ave Se,
Grand Rapids, MI 49503-4502
(616) 685-5000
Not Available

Map and Direction




Physician's Profile

Full NameJustin R Staley
GenderMale
SpecialityEmergency Medicine
Experience6 Years
Location200 Jefferson Ave Se, Grand Rapids, Michigan
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Justin R Staley attended and graduated from Marian University College Of Osteopathic Medicine in 2020
  NPI Data:
  • NPI Number: 1164044830
  • Provider Enumeration Date: 05/15/2020
  • Last Update Date: 09/09/2026
  Medicare PECOS Information:
  • PECOS PAC ID: 4183075088
  • Enrollment ID: I20240104002536

Medical Identifiers

Medical identifiers for Justin R Staley such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1164044830NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207P00000XEmergency Medicine 02008975A (Indiana)Secondary
390200000XStudent In An Organized Health Care Education/training Program (* (Not Available))Secondary
207P00000XEmergency Medicine 5101026712 (Michigan)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Trinity Health Grand Rapids HospitalGrand rapids, MIHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Grand River Emergency Medical Group Plc327442590541

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Justin R Staley allows following entities to bill medicare on his behalf.
Entity NameGrand River Emergency Medical Group PLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1114929353
PECOS PAC ID: 3274425905
Enrollment ID: O20040327000079
Entity NameLake Michigan Emergency Specialists, PLLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1124574520
PECOS PAC ID: 0749569242
Enrollment ID: O20161123001655
Entity NameLake Michigan Observation Services PLLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1518626043
PECOS PAC ID: 3375938889
Enrollment ID: O20220321000912

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Justin R Staley is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Justin R Staley, DO
1415 E Shorewood Dr,
Norton Shores, MI 49441-5288

Ph: (317) 219-8571		Justin R Staley, DO
200 Jefferson Ave Se,
Grand Rapids, MI 49503-4502

Ph: (616) 685-5000

Reviews and Comments


Emergency Medicine Doctors in Grand Rapids, MI

Kristin Inger, M.D.
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Practice Location: 145 Michigan St Ne Ste 3410, Grand Rapids, MI 49503
Phone: 616-391-9945    
Dr. Adam Michael Anderson, MD
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Practice Location: 200 Jefferson Ave Se, Grand Rapids, MI 49503
Phone: 616-685-5000    
Mark Greenwood, DO
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Phone: 616-391-5310    
Raymond Scurek, MD
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Practice Location: 100 Michigan St Ne, Grand Rapids, MI 49503
Phone: 616-391-1680    Fax: 616-285-0846
Mark G Kanitz, MD
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Medicare: Not Enrolled in Medicare
Practice Location: 100 Michigan St Ne, Grand Rapids, MI 49503
Phone: 616-391-1680    
Dr. Calista Kaitlyn Prohaska, DO
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Practice Location: 100 Michigan St Ne # Mc188, Grand Rapids, MI 49503
Phone: 616-391-1680    
Dr. Sara Rish Urquhart, MD
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Medicare: Accepting Medicare Assignments
Practice Location: 1840 Wealthy St Se, Grand Rapids, MI 49506
Phone: 616-391-1730    Fax: 616-285-0846

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.