Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Zachary Hartley-Blossom, MD

Individual provider Diagnostic Radiology Physician · NPI 1225567902

Zachary Hartley-Blossom, MD is a Diagnostic Radiology in Grand Rapids, Michigan. Graduated from Oakland Univ, William Beaumont School of Medicine in 2017, 9 years ago. Practices with Advanced Radiology Services PC, a 252-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in Massachusetts, Michigan and Rhode Island.

Years since qualifying
9
Trained at
Oakland Univ, William Beaumont School of Medicine
Licensed in
MA, MI, RI
In the registry since
2017
Specialties on file
4
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

3264 N Evergreen Dr NE
Grand Rapids, MI 49525-9746
Phone: (616) 363-7272
Fax: (616) 361-5828
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 55 Fruit St, Boston, MA 02114-2621 — (617) 726-2000
  • 593 Eddy St, Providence, RI 02903-4923 — (401) 444-5174
  • 125 Metro Center Blvd, Warwick, RI 02886-1768 — (140) 192-1920

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence 4301508654 (MI)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence MD17244 (RI)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 290918 (MA)
Surgery Physician Taxonomy 208600000X · Licence LP04037 (RI)

Record details

NPI number1225567902
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 7, 2017
Last updated in NPPESDecember 18, 2023
Certification dateDecember 18, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolOAKLAND UNIV, WILLIAM BEAUMONT SCHOOL OF MEDICINE
Graduated 2017 (9 years in practice)
Group practice Advanced Radiology Services Pc — 252 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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