NPIMap

Individual provider Active NPI

Samuel Terranova, NP

  • Primary Care Nurse Practitioner
  • Grand Rapids, MI
National Provider Identifier
1154201689
Registry record updated Jan 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
4704356674 Issued in MI
Practice address
770 Kenmoor Ave SE Ste 100
Grand Rapids, MI 49546-8602
Phone
(616) 272-3533
Fax
(616) 259-4839
NPI assigned
Sep 4, 2025
Last updated
Jan 20, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 4704356674 MI Primary

Addresses

Primary practice location

770 Kenmoor Ave SE Ste 100
Grand Rapids, MI 49546-8602

Mailing address

801 Rosehill Rd
Jackson, MI 49202-1762
Phone (517) 212-2008

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251029002909 MI Practitioner - Nurse Practitioner 4789173808 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northview Health Specialists, PLLCGroup PAC ID 9638422835, 24 clinicians

Practice addresses (Care Compare)

2080 44TH St SE
Kentwood, MI 49508-5299
Phone (616) 685-8100

770 Kenmoor Ave SE
Suite 100
Grand Rapids, MI 49546-8602
Phone (616) 272-3533

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704356674MIMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northview Health Specialists, PLLC CurrentSince Sep 24, 2025 Accepting new patients
Careline Palliative Care LLC Primary Care CurrentSince Sep 24, 2025 Accepting new patients
Careline Hmi300 LLC CurrentSince Sep 8, 2025 Accepting new patients
Provider Partners Care Management LP CurrentSince Jan 26, 2026 Accepting new patients
Northview Medical House Calls PLC CurrentSince Sep 24, 2025 Accepting new patients
Harpal S Jande MD PC PastSince Jun 15, 2021 Accepting new patients
Premier Heart Associates, Inc PastSince Sep 24, 2025 Accepting new patients
Advantage Health Saint Mary's Medical Group Past Accepting new patients

Locations

8820 Columbia 100 Pkwy
Ste 430
Columbia, MD 21045
Phone (317) 701-2379

770 Kenmoor Ave SE
Ste 100
Grand Rapids, MI 49546
Phone (616) 272-3533

801 Rosehill Rd
Jackson, MI 49202
Phone (517) 212-2008

4760 Fashion Square Blvd
Ste L1
Saginaw, MI 48604
Phone (989) 282-4003

Organizations & group practices 9

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 3

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": "1756944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768867200000",
    "number": "1154201689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 ROSEHILL RD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492021762",
            "telephone_number": "517-212-2008",
            "fax_number": "517-212-9023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 KENMOOR AVE SE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468602",
            "telephone_number": "616-272-3533",
            "fax_number": "616-259-4839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRANOVA",
        "first_name": "SAMUEL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-09-04",
        "last_updated": "2026-01-20",
        "certification_date": "2026-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "4704356674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.