Misty Rae Ledesma, NP-C
Individual provider Active NPI Primary Care Nurse Practitioner · Dowagiac, MI
NPI 1154959591 · NPPES record last updated Nov 9, 2023
Key facts
- NPI
- 1154959591
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Primary Care Nurse Practitioner 363LP2300X
- License
- 4204244777 (MI)
- Practice address
- 32652 Kno
Dowagiac, MI 49047-9805 - Phone
- (269) 782-4141
- Fax
- (269) 783-1236
- NPI assigned
- Mar 31, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 10
Medicare Care Compare profile
Merit-based Incentive Payment System (MIPS)
- Final score
- 67.89 of 100
- Quality
- 100
- Promoting interoperability
- 0
- Improvement activities
- 40
- Cost
- 76.31
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MI, TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200602002316 | MI | Practitioner - Nurse Practitioner | 4587085329 | Reassigns benefits to 4 organizations |
| I20240326003848 | TX | Practitioner - Nurse Practitioner | 4587085329 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704244777 | MI | MD | Nurse Practitioner |
| 4204244777 | MI | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West Michigan Cancer Center | Nurse Practitioner | Current |
Accepting new patients |
| Ascension Medical Group Promed | Current | Accepting new patients | |
| Ascension Borgess Lee Hospital | Current |
Accepting new patients | |
| West Michigan Cancer Center | Nurse Practitioner | Current |
Accepting new patients |
| Ascension Medical Group Promed | Current |
Accepting new patients | |
| Promed Healthcare | Current |
Accepting new patients | |
| Ascension Borgess Lee Hospital | Current |
Accepting new patients | |
| Pokagon Band of Potawatomi Indians | Current |
Accepting new patients | |
| Ascension Borgess Allegan Hospital | Current |
Accepting new patients | |
| Ascension Borgess Allegan Hospital | Current |
Accepting new patients |
Locations
3180 Solutions Ctr
Chicago, IL 60677
555 Linn St
Allegan, MI 49010
Phone (269) 673-8424
420 W High St
Dowagiac, MI 49047
Phone (269) 782-8681
32652 Kno
Dowagiac, MI 49047
Phone (269) 782-4141
1717 Shaffer St
Ste 002
Kalamazoo, MI 49048
200 N Park St
Kalamazoo, MI 49007
Phone (269) 373-7453
1521 Gull Rd
Kalamazoo, MI 49048
Phone (269) 226-5165
7901 Angling Rd
Portage, MI 49024
Phone (269) 324-8405
600 S Lakeview Ave
Ste 106
Sturgis, MI 49091
Phone (269) 625-9132
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 4704244777 | MI | |
| Primary Care Nurse Practitioner | 363LP2300X | 4204244777 | MI | Yes |
Addresses
Primary practice location
32652 Kno
Dowagiac, MI 49047-9805
Mailing address
60207 65TH St
Hartford, MI 49057-8711
Phone (269) 674-9909
Other practice location 1
1521 Gull Rd
Kalamazoo, MI 49048-1640
Phone (269) 226-7000
Other practice location 2
600 S Lakeview Ave Ste 106
Sturgis, MI 49091-2373
Phone (269) 625-9132
Other providers in Dowagiac, MI
- Lakeland Community Hospital Watervliet
- Lakeland Community Hospital Watervliet
- Lakeland Immediate Care Center
- Lakeland Immediate Care Center
- Alicia Jean Lane
- Lee Memorial Hospital
- Lee Memorial Hospital Corporation
- Lee Memorial Hospital Corporation
- Lee Memorial Hospital Corporation
- Living Alternatives Fo
All providers in Dowagiac, MI · Primary Care Nurse Practitioner in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 9, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.