Individual provider Active NPI

Julie A Anderson, PA-C

  • Surgical Physician Assistant
  • Muskegon, MI
National Provider Identifier
1114990447
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
1560 E Sherman Blvd Ste 309
Muskegon, MI 49444-1850
Phone
(231) 672-8643
Fax
(231) 672-8651
NPI assigned
Feb 8, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X Primary

Addresses

Primary practice location

1560 E Sherman Blvd Ste 309
Muskegon, MI 49444-1850

Mailing address

PO Box 1847
Muskegon, MI 49443-1847
Phone (231) 727-4444

Other practice location 1

100 Michigan St NE, MC 103
Suite 8830
Grand Rapids, MI 49503-2560
Phone (616) 459-7258

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
I20040618000658 MI Practitioner - Physician Assistant 4688659311 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Partners Sub-Specialty ServicesGroup PAC ID 3274504105, 33 clinicians

Practice addresses (Care Compare)

1277 Mercy Dr
Muskegon, MI 49444-4605
Phone 23167261862

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.79 of 100Reported as group
Quality
96.38
Improvement activities
40
Cost
77.38

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners Past Accepting new patients
West Michigan Cardiothoracic Surgeons PLC PastSince Jan 1, 1995 Accepting new patients

Organizations & group practices 3

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

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": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1114990447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1847",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494431847",
            "telephone_number": "231-727-4444",
            "fax_number": "231-728-4789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 E SHERMAN BLVD STE 309",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441850",
            "telephone_number": "231-672-8643",
            "fax_number": "231-672-8651"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 MICHIGAN ST NE, MC 103",
            "address_2": "SUITE 8830",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495032560",
            "country_code": "US",
            "telephone_number": "616-459-7258",
            "fax_number": "616-459-5215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JULIE",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

Verify at the official NPI Registry.