Individual provider Active NPI

Nicole Marie Tompkins, PA

  • Physician Assistant
  • Ludington, MI
National Provider Identifier
1003213786
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601007257 Issued in MI
Practice address
922 Lawndale St
Ludington, MI 49431-1928
Phone
(231) 845-7380
NPI assigned
Nov 25, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601007257 MI Primary

Addresses

Primary practice location

922 Lawndale St
Ludington, MI 49431-1928

Mailing address

100 Michigan St NE
Mc845
Grand Rapids, MI 49503-2560

Other names 1

  • Nicole Marie Dehaan Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150119000495 MI Practitioner - Physician Assistant 6002130242 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4069 Lake Dr SE
Grand Rapids, MI 49546-8816

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.36 of 100Reported as apm
Quality
83.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners CurrentSince Sep 15, 2024 Accepting new patients
Spectrum Health Primary Care Partners Current Accepting new patients
Newaygo County General Hospital Association CurrentSince Jul 31, 2024 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Sep 15, 2024 Accepting new patients
Newaygo County General Hospital Association CurrentSince Jul 31, 2024 Accepting new patients
Memorial Medical Center of West Michigan CurrentSince Jul 31, 2024 Accepting new patients
Memorial Medical Center of West Michigan CurrentSince Jul 31, 2024 Accepting new patients

Locations

212 S Sullivan Ave
Fremont, MI 49412
Phone (231) 924-1212

230 W Oak St
Fremont, MI 49412
Phone (231) 924-1305

444 Michigan St NE
#288
Grand Rapids, MI 49503
Phone (616) 267-7469

100 Michigan St NE
#A721
Grand Rapids, MI 49503
Phone (616) 391-3139

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

230 S Maple St
Grant, MI 49327
Phone (231) 834-5995

2481 N 72nd Ave
Hart, MI 49420
Phone (231) 873-2163

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

7 Atkinson Dr
Ste 200
Ludington, MI 49431
Phone (231) 843-2664

922 Lawndale St
Ludington, MI 49431
Phone (231) 845-7380

1 Atkinson Dr
Ludington, MI 49431
Phone (231) 843-2591

Interoperability endpoints

  • Direct secure messaging: ntompkins89848@epic00.corewelldirect.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1416873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1003213786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "922 LAWNDALE ST",
            "city": "LUDINGTON",
            "state": "MI",
            "postal_code": "494311928",
            "telephone_number": "231-845-7380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMPKINS",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-25",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "DEHAAN",
            "middle_name": "MARIE",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ludington, MI

Sources for this page

Verify at the official NPI Registry.