Erin Elizabeth Van Tiem, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601005456 Issued in MI

Practice address

990 W Ann Arbor TRL Ste 205
Plymouth, MI 48170-1686

Phone

(734) 455-6881

Fax

(734) 455-6891

NPI assigned

May 13, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 3

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Loma Linda University School of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Forefront Dermatology SCGroup PAC ID 3779471701, 650 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Health Ann Arbor Hospital Hospital, Ann Arbor, MI, CCN 230156

Merit-based Incentive Payment System (MIPS)

Final score

97.45 of 100Reported as group

Promoting interoperability

97

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ev4246@forefrontdermatology.emadirect.md

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.

• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Grand Rapids, MI
  • NPI 1912347923
  Medicare reassignment Care Compare group NPD
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Columbus, OH
  • NPI 1063365385
  NPD
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Manitowoc, WI
  • NPI 1578515904
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Joseph Mercy Hospital

  • General Acute Care Hospital
  • Ypsilanti, MI
  • NPI 1780658443
  Care Compare affiliation

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

{
    "created_epoch": "1242172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1255565685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9008",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 W ANN ARBOR TRL STE 205",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701686",
            "telephone_number": "734-455-6881",
            "fax_number": "734-455-6891"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25500 Meadowbrook Rd Ste 180",
            "address_purpose": "LOCATION",
            "city": "Novi",
            "state": "MI",
            "postal_code": "483751882",
            "country_code": "US",
            "telephone_number": "248-940-1927",
            "fax_number": "248-940-1928",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "305 E Eisenhower Pkwy Ste 320",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481083348",
            "country_code": "US",
            "telephone_number": "734-800-2055",
            "fax_number": "734-800-2056",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN TIEM",
        "first_name": "ERIN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-13",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601005456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "EV4246@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "990 W Ann Arbor Trl Ste 205",
            "city": "Plymouth",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481701686",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "EV4246@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "25500 Meadowbrook Rd Ste 180",
            "city": "Novi",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483751882",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "EV4246@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "305 E Eisenhower Pkwy Ste 320",
            "city": "Ann Arbor",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481083348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Deborah Jo Vallandingham, MSW
• Diana Alejandra Valles-Roque
• Amanda Vallone
• Rachel Van Dyke, SLP
• Laura E Van Reyendam
• Alicia Vanbebber
• Gary Louis Vance, DDS
• Kathleen Vandel, M.A. CCC-SLP
• Sheila Vander
• Andrea Vanderhorst

• Physician Assistant in Plymouth, MI
• Providers in Plymouth, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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.