Grand River Surgery Center, LLC
NPI 1124605910 · Ambulatory Surgical Clinic/Center · East Lansing, MI
Enrolled with Medicare as Part B Supplier - Ambulatory Surgical Center · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Grand River Surgery Center, LLC is a Ambulatory Surgical Clinic/Center organization in East Lansing, MI (NPI 1124605910).
Provider details
- NPI number
- 1124605910
- Entity type
- Organization
- Primary specialty
- Ambulatory Surgical Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Douglas Dietzel, Ceo(517) 488-8800
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
5 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)28% of score
5,003 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Injection, Bupivacaine Liposome, 1 MgC9290 | 4,921 | $1 |
| Full Thickness Skin Graft to Nose, Ears, Eyelids, Or Lips, 20.0 Sq Cm Or Less15260 | 19 | $882 |
| Incision of Tendon Covering of Finger26055 | 19 | $643 |
| Release And/Or Relocation of Hand Nerve64721 | 17 | $837 |
| Preparation of Skin Graft Site of Face, Scalp, Eyelids, Mouth, Neck, Ears, Around Eyes, Genitals, Hands, Feet, Fingers, Or Toes, 100.0 Sq Cm Or 1% Body Area for Infants and Children, Or Less15004 | 14 | $152 |
| Repair of Wound of Eyelids, Nose, Ears, Or Lips By Transferring Skin, 10.0 Sq Cm Or Less14060 |
Practice location
Mailing address
Registry dates
- Enumerated
- 2021-03-26
- Last updated
- 2021-12-08
- Certified
- 2021-12-08
Frequently asked questions
- What is Grand River Surgery Center, LLC's NPI number?
- Grand River Surgery Center, LLC's National Provider Identifier (NPI) is 1124605910, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Grand River Surgery Center, LLC?
- Grand River Surgery Center, LLC is classified in the NPPES registry as Ambulatory Surgical Clinic/Center (Ambulatory Health Care Facilities).
- Where is Grand River Surgery Center, LLC located?
- Grand River Surgery Center, LLC's practice location on file with NPPES is 1090 Trowbridge Rd Ste a, East Lansing, MI 48823-5220.
- What is Grand River Surgery Center, LLC's phone number?
- The practice phone number listed in the NPPES registry for Grand River Surgery Center, LLC is (517) 220-0240.
- Does Grand River Surgery Center, LLC accept Medicare?
- Grand River Surgery Center, LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Grand River Surgery Center, LLC?
- The authorized official listed on Grand River Surgery Center, LLC's NPPES record is Douglas Dietzel, Ceo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Grand River Surgery Center, LLC's NPI active?
- Yes — Grand River Surgery Center, LLC's NPI (1124605910) is active in the NPPES registry as of the last update on 2021-12-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.