Michael Alan Jansen, PHD, LP

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

6301013771 Issued in MI

Practice address

854 Washington Ave Ste 330
Holland, MI 49423-7141

Phone

(616) 355-3926

Fax

(616) 393-6651

NPI assigned

Nov 8, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Holland Community HospitalGroup PAC ID 0446157291, 174 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michael.jansen@hhobh.eclinicaldirectplus.com

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.

• Holland Community Hospital

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Holland, MI
  • NPI 1780888099
  Medicare reassignment Care Compare group NPD
• Holland Community Hospital

  • Pulmonary Disease Physician
  • Holland, MI
  • NPI 1477166502
  NPD (past)

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

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394755200000",
    "number": "1154501062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "854 WASHINGTON AVE STE 330",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494237141",
            "telephone_number": "616-355-3926",
            "fax_number": "616-393-6651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "854 WASHINGTON AVE STE 330",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494237141",
            "telephone_number": "616-355-3926",
            "fax_number": "616-393-6651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANSEN",
        "first_name": "MICHAEL",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "PHD, LP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-08",
        "last_updated": "2014-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301013771",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MI",
            "license": "6301013771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aimee M James, SOCIAL WORKER
• Kelly Marie James, OD
• Angela L Jammer, OD
• Zoie Jamrog
• Luke A Jansa
• Ellen Marie Jansyn, MD
• Anne Japinga, MS, AT, ATC
• Tiffany Jarois, D.O
• Elizabeth Jaros, LLMSW
• Anne Elizabeth Jarzembowski, LMSW

• Clinical Child & Adolescent Psychologist in Holland, MI
• Providers in Holland, MI by specialty
• Clinical Child & Adolescent Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.