Individual provider Active NPI

Dana M Pigorsh, PA-C

  • Medical Physician Assistant
  • Grand Rapids, MI
National Provider Identifier
1295963601
Registry record updated Nov 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
145 Michigan St NE Ste 3100
Grand Rapids, MI 49503-2563
Phone
(616) 954-9800
Fax
(616) 954-1724
NPI assigned
Jun 24, 2009
Last updated
Nov 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MI Primary

Addresses

Primary practice location

145 Michigan St NE Ste 3100
Grand Rapids, MI 49503-2563

Mailing address

PO Box 289
Jenison, MI 49429-0289
Phone (616) 457-9000

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
I20090902000340 MI Practitioner - Physician Assistant 2466507199 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

145 Michigan St NE
Suite 3100
Grand Rapids, MI 49503-2563
Phone (616) 954-9800

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners Current Accepting new patients
Cancer & Hematology Centers of Western Mi, P.C. CurrentSince Dec 1, 2024 Accepting new patients
Cancer & Hematology Centers of Western Mi, P.C. Past Accepting new patients
Platinum Living LLC Past Accepting new patients
Ahsl Holland Operations, LLC Past Accepting new patients

Locations

15100 220th Ave
Big Rapids, MI 49307
Phone (231) 515-9410

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

145 Michigan St NE
Ste 3100
Grand Rapids, MI 49503
Phone (616) 954-9800

2249 Wealthy St SE
Ste 110
Grand Rapids, MI 49506
Phone (616) 391-4600

5800 Foremost Dr SE
Ste 100
Grand Rapids, MI 49546
Phone (616) 954-5554

710 Kenmoor Ave SE
Ste 200
Grand Rapids, MI 49546
Phone (616) 588-7246

12460 Riley St
Holland, MI 49424
Phone (616) 399-1308

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

Organizations & group practices 6

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 2

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": "1245801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1295963601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 289",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "494290289",
            "telephone_number": "616-457-9000",
            "fax_number": "616-457-3801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 MICHIGAN ST NE STE 3100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032563",
            "telephone_number": "616-954-9800",
            "fax_number": "616-954-1724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIGORSH",
        "first_name": "DANA",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-24",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.