Misty Rae Ledesma, NP-C

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

4204244777 Issued in MI

Practice address

32652 Kno
Dowagiac, MI 49047-9805

Phone

(269) 782-4141

Fax

(269) 783-1236

NPI assigned

Mar 31, 2020

Last updated

Nov 9, 2023By the provider in NPPES

Sex

Female

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, TX2 enrollments

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 2

Merit-based Incentive Payment System (MIPS)

Final score

67.89 of 100Reported as group

Quality

100

Promoting interoperability

0

Improvement activities

40

Cost

76.31

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Beacon Allegan Inc

  dba Ascension Borgess Allegan Hospital Outpatient Clinic

  • Multi-Specialty Clinic/Center
  • Allegan, MI
  • NPI 1144531252
  Medicare reassignment NPD
• Beacon Dowagiac Inc

  dba Beacon Dowagiac

  • Critical Access Hospital
  • Dowagiac, MI
  • NPI 1194771030
  Medicare reassignment NPD
• Beacon Medical Group Michigan Inc

  dba Beacon Medical Group Michigan

  • Family Medicine Physician
  • Portage, MI
  • NPI 1497709869
  Medicare reassignment NPD
• Pokagon Band of Potawatomi Indians

  dba Pokagon Health Service

  • Federally Qualified Health Center (FQHC)
  • Dowagiac, MI
  • NPI 1497833271

  TX

  Medicare reassignment NPD
• West Michigan Cancer Center

  • Medical Oncology Physician
  • Kalamazoo, MI
  • NPI 1447261730

  Nurse Practitioner

  Medicare reassignment NPD
• Beacon Allegan Inc

  dba Beacon Allegan

  • Hospitalist Physician
  • Allegan, MI
  • NPI 1992668925
  NPD
• Beacon Dowagiac Inc

  dba Beacon Kalamazoo

  • Hospitalist Physician
  • Dowagiac, MI
  • NPI 1467315499
  NPD
• Beacon Medical Group Michigan Inc

  dba Beacon Medical Group Michigan

  • Internal Medicine Physician
  • Kalamazoo, MI
  • NPI 1720009954
  NPD
• Promed Healthcare

  dba Borgess Women's Health

  • Rural Health Clinic/Center
  • Plainwell, MI
  • NPI 1487708830
  NPD
• West Michigan Cancer Center

  dba West Michigan Cancer Center Radiation Oncology

  • Radiation Oncology Physician
  • Kalamazoo, MI
  • NPI 1588778484

  Nurse Practitioner

  NPD

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

{
    "created_epoch": "1585612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1154959591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60207 65TH ST",
            "city": "HARTFORD",
            "state": "MI",
            "postal_code": "490578711",
            "telephone_number": "269-674-9909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32652 KNO",
            "city": "DOWAGIAC",
            "state": "MI",
            "postal_code": "490479805",
            "telephone_number": "269-782-4141",
            "fax_number": "269-783-1236"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1521 Gull Rd",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490481640",
            "country_code": "US",
            "telephone_number": "269-226-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 S Lakeview Ave Ste 106",
            "address_purpose": "LOCATION",
            "city": "Sturgis",
            "state": "MI",
            "postal_code": "490912373",
            "country_code": "US",
            "telephone_number": "269-625-9132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEDESMA",
        "first_name": "MISTY",
        "middle_name": "RAE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-31",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704244777",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "4204244777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lakeland Community Hospital Watervliet (Corewell Health Watervliet Hospital)
• Lakeland Community Hospital Watervliet (Corewell Health Watervliet Hospital)
• Lakeland Immediate Care Center (Cass Family Clinic Dowagiac Pharmacy)
• Lakeland Immediate Care Center (Cass Family Clinic-Dowagiac)
• Alicia Jean Lane, MSN, RN, FNP-C
• Lee Memorial Hospital
• Lee Memorial Hospital Corporation (Borgess Lee Medical Group)
• Lee Memorial Hospital Corporation (Borgess Lee Medical Group)
• Lee Memorial Hospital Corporation (Borgess Lee Medical Group)
• Living Alternatives Fo

• Primary Care Nurse Practitioner in Dowagiac, MI
• Providers in Dowagiac, MI by specialty
• Primary Care Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; 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.