Individual provider Active NPI

Jayne Elizabeth Paulson, M.D.

  • Surgery Physician
  • Grand Rapids, MI
National Provider Identifier
1144315920
Registry record updated Feb 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
4301070568 Issued in MI
Practice address
145 Michigan St NE Ste 4400
Grand Rapids, MI 49503-2564
Phone
(616) 486-6333
NPI assigned
Oct 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 4301070568 MI Primary

Addresses

Primary practice location

145 Michigan St NE Ste 4400
Grand Rapids, MI 49503-2564

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
4394146MedicaidMI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address Jayne.Paulson@epic00.shdirect.org
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120626000268 MI Practitioner - General Surgery 6507021540 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Michigan State University College of Human Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

145 Michigan St NE
Grand Rapids, MI 49503-2564

145 Michigan St NE
4100 Corewell Health Medical Group West
Grand Rapids, MI 49503-2567
Phone (616) 486-6314

1840 Wealthy St SE
Corewell Health Medical Group West
Grand Rapids, MI 49506-2921
Phone (616) 885-5000

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy21
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Hospitals CurrentSince Aug 1, 2015 Accepting new patients
Spectrum Health Primary Care Partners Current Accepting new patients
Spectrum Health Hospitals CurrentSince Aug 1, 2015 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Sep 4, 2012 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Sep 4, 2012 Accepting new patients

Locations

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

4069 Lake Dr SE
Ste 117
Grand Rapids, MI 49546
Phone (616) 267-8600

1900 Wealthy St SE
Ste 180
Grand Rapids, MI 49506
Phone (616) 458-1200

145 Michigan St NE
Ste 4400
Grand Rapids, MI 49503
Phone (616) 391-9945

2249 Wealthy St SE
Ste 110
Grand Rapids, MI 49506
Phone (616) 391-4600

100 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1680

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

Interoperability endpoints

  • Direct secure messaging: jayne.paulson@epic00.shdirect.org
  • Direct secure messaging: jpaulson4407@epic00.corewelldirect.org

Organizations & group practices 5

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1144315920",
    "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": "145 MICHIGAN ST NE STE 4400",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032564",
            "telephone_number": "616-486-6333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULSON",
        "first_name": "JAYNE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301070568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4394146",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Jayne.Paulson@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "145 Michigan St NE Ste 4400",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495032564",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "145 Michigan St NE Ste 4400",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495032564",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.