Individual provider Active NPI

Nicole Markiewicz, NP

  • Family Nurse Practitioner
  • Grand Rapids, MI
National Provider Identifier
1073997698
Registry record updated Jan 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704274234 Issued in MI
Practice address
6735 Cascade Rd SE
Grand Rapids, MI 49546-6887
Phone
(616) 975-2550
NPI assigned
Jul 14, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704274234 MI Primary

Addresses

Primary practice location

6735 Cascade Rd SE
Grand Rapids, MI 49546-6887

Mailing address

1900 44TH St SE
Kentwood, MI 49508-5008

Other names 1

  • Nicole Martini Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nmarkiewicz44388@direct.trinity-health.org Direct

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
I20150807014142 MI Practitioner - Nurse Practitioner 4385958081 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Michigan State University College of Human Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

933 3 Mile Rd NW
Suite 210
Grand Rapids, MI 49544-1673
Phone (616) 685-8150

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704274234MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Health Saint Mary's Medical Group CurrentSince Sep 1, 2015 Accepting new patients
Advantage Health/Saint Mary's Medical Group Current Accepting new patients
Advantage Health/Saint Mary's Medical Group CurrentSince Sep 1, 2015 Accepting new patients
Advantage Health Saint Mary's Medical Group Past Accepting new patients

Locations

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

245 Cherry St SE
Ste 100
Grand Rapids, MI 49503
Phone (616) 685-3200

933 3 Mile Rd NW
Ste 210
Walker, MI 49544
Phone (616) 685-7985

Interoperability endpoints

  • Direct secure messaging: nmarkiewicz44388@direct.trinity-health.org

Organizations & group practices 4

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 1

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": "1436832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1073997698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 44TH ST SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495085008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6735 CASCADE RD SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466887",
            "telephone_number": "616-975-2550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKIEWICZ",
        "first_name": "NICOLE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-14",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704274234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nmarkiewicz44388@direct.trinity-health.org",
            "affiliation": "N",
            "endpointDescription": "MHPP GR Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "6735 Cascade Rd SE",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495466887",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "MARTINI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.