Individual provider Active NPI

Melissa Marie Eisenhauer, PA

  • Physician Assistant
  • Holland, MI
National Provider Identifier
1295391217
Registry record updated May 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601009405 Issued in MI
Practice address
602 Michigan Ave Ste 102
Holland, MI 49423-4918
Phone
(616) 494-8724
NPI assigned
May 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601009405 MI Primary

Addresses

Primary practice location

602 Michigan Ave Ste 102
Holland, MI 49423-4918

Mailing address

100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560

Other names 1

  • Melissa Marie Huisken Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mhuisken242500@epic00.shdirect.org
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190628001056 MI Practitioner - Physician Assistant 0345574075 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Michigan Ave NE
Grand Rapids, MI 49503-2560

100 Michigan St NE RM
280 Corewell Health Medical Group West
Grand Rapids, MI 49503-2560
Phone (616) 267-0115

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

602 Michigan Ave
Suite 102
Holland, MI 49423-4918
Phone (616) 494-8724

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601009405MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners CurrentSince Jul 19, 2019 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jul 19, 2019 Accepting new patients
Spectrum Health Hospitals CurrentSince Jul 19, 2019 Accepting new patients
Spectrum Health Hospitals CurrentSince Jul 19, 2019 Accepting new patients

Locations

100 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1680

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

602 Michigan Ave
Ste 102
Holland, MI 49423
Phone (616) 392-3824

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

Interoperability endpoints

  • Direct secure messaging: meisenhauer242500@epic00.corewelldirect.org

Organizations & group practices 4

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": "1557878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779062400000",
    "number": "1295391217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 MICHIGAN AVE STE 102",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494234918",
            "telephone_number": "616-494-8724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENHAUER",
        "first_name": "MELISSA",
        "middle_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-15",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601009405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mhuisken242500@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "100 Michigan St NE",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495032560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "100 Michigan St NE",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495032560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "HUISKEN",
            "middle_name": "MARIE",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Holland, MI

Sources for this page

Verify at the official NPI Registry.