Active NPI
Tracy A Reese, PA-C
- Medical Physician Assistant
- Kalamazoo, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 5601004897
- Practice address
- 1722 Shaffer Street
Suite 3
Kalamazoo, MI 49048 - Phone
- (269) 226-5197
- Fax
- (269) 552-0910
- NPI assigned
- Oct 12, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 5601004897 | MI | Primary |
Addresses
Primary practice location
1722 Shaffer Street
Suite 3
Kalamazoo, MI 49048
Mailing address
1722 Shaffer St.
Suite 3
Kalamazoo, MI 49048
Phone (269) 226-5197
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5601004897 | Other | MI | MICHIGAN LICENSE |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1722 Shaffer St
Kalamazoo, MI 49048-1633
Phone (269) 343-1555
7901 Angling Rd
Portage, MI 49024-0714
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Promed Healthcare | Current | Accepting new patients | |
| Ascension Medical Group Promed | Current | Accepting new patients | |
| Indiana Hospitalists, PC | Past | Accepting new patients | |
| Ascension Medical Group Promed | Past | Accepting new patients |
Locations
1722 Shaffer St
Ste 1
Kalamazoo, MI 49048
Phone (269) 381-3963
3025 Gull Rd
Kalamazoo, MI 49048
Phone (269) 343-1264
1722 Shaffer St
Ste 3
Kalamazoo, MI 49048
Phone (269) 337-6373
1521 Gull Rd
Kalamazoo, MI 49048
Phone (269) 226-5165
411 Naomi St
Plainwell, MI 49080
Phone (269) 685-0700
7901 Angling Rd
Portage, MI 49024
Phone (269) 324-8405
600 S Lakeview Ave
Ste 105
Sturgis, MI 49091
Phone (269) 651-9470
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 and National Provider Directory roles.
-
- Family Medicine Physician
- Portage, MI
- NPI 1497709869
-
- Internal Medicine Physician
- Portage, MI
- NPI 1538299631
-
- Rural Health Clinic/Center
- Plainwell, MI
- NPI 1487708830
-
- Hospitalist Physician
- Richmond, IN
- NPI 1164485710
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Long Term Care Hospital
- Plainwell, MI
- NPI 1154504892
Long-term care hospital
-
- General Acute Care Hospital
- Kalamazoo, MI
- NPI 1568416311
-
- General Acute Care Hospital
- Coldwater, MI
- NPI 1063471639
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678838400000",
"number": "1295824795",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1722 SHAFFER ST.",
"address_2": "SUITE 3",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "49048",
"telephone_number": "269-226-5197",
"fax_number": "269-552-0910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1722 SHAFFER STREET",
"address_2": "SUITE 3",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "49048",
"telephone_number": "269-226-5197",
"fax_number": "269-552-0910"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REESE",
"first_name": "TRACY",
"middle_name": "A",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-12",
"last_updated": "2023-03-15",
"certification_date": "2023-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "MI",
"license": "5601004897",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MICHIGAN LICENSE",
"identifier": "5601004897",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Kalamazoo, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.