NPIMap

Individual provider Active NPI

Miriam Yvonne Veldt, MD

  • Family Medicine Physician
  • Portage, MI
National Provider Identifier
1295965499
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301095330 Issued in MI
Practice address
5036 Stonehenge Dr
Portage, MI 49024-5727
Phone
(269) 716-3574
NPI assigned
Jul 22, 2009
Last updated
Oct 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301095330 MI Primary

Addresses

Primary practice location

5036 Stonehenge Dr
Portage, MI 49024-5727

Mailing address

5036 Stonehenge Dr
Portage, MI 49024-5727
Phone (269) 716-3574

Other names 1

  • Miriam Gibson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130930000229 MI Practitioner - Family Practice 9032360474 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Powerback Rehabilitation LLCGroup PAC ID 2365359932, shared by 106 NPIs, 600 clinicians

Practice addresses (Care Compare)

3951 W Milham Ave
Portage, MI 49024-1088
Phone (269) 447-1689

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301095330MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Medical Care PLLC Family Medicine CurrentSince Nov 8, 2025 Accepting new patients
Mi Pacs 2 PC CurrentSince Jul 1, 2024 Accepting new patients
Vpa PC Family Medicine CurrentSince Aug 5, 2013 Accepting new patients
Vpa PC Family Medicine CurrentSince Aug 5, 2013 Accepting new patients
Vpa PC Family Medicine Current Accepting new patients
Michigan Post-Acute Medical Services 1 PC CurrentSince Jul 1, 2024 Accepting new patients
CS Pacs 3 Midwest LLC CurrentSince Oct 21, 2024 Accepting new patients
Crestview SNF, LLC Past Accepting new patients
St. Ann's Home Inc. Past Accepting new patients
Calhoun County Medical Care Facility Past Accepting new patients
Atrium Heritage LLC Past Accepting new patients
Optalis Wyoming Opco, LLC Past Accepting new patients
Cliffside Company L L C Past Accepting new patients

Locations

22600 W Main St
Armada, MI 48005
Phone (734) 508-4569

1484 Straits Dr
Ste 5
Bay City, MI 48706
Phone (989) 667-8740

12200 Broadbent Rd
Lansing, MI 48917
Phone (517) 731-6200

3310 W Commerce Rd
Milford, MI 48380
Phone (248) 685-1400

555 Highland Ave
Milford, MI 48381
Phone (248) 684-1564

2205 Jolly Rd
Ste A
Okemos, MI 48864
Phone (517) 347-4085

2205 Jolly Rd
Ste B
Okemos, MI 48864
Phone (517) 347-4085

2725 Airview Blvd
Ste 105
Portage, MI 49002
Phone (269) 349-8386

500 Kirts Blvd
Ste 100
Troy, MI 48084
Phone (214) 824-6000

500 Kirts Blvd
Ste 200
Troy, MI 48084
Phone (248) 824-6060

6827 Whitehall Rd
Whitehall, MI 49461
Phone (231) 893-8730

625 36th St SW
Wyoming, MI 49509
Phone (517) 481-3715

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Optalis Health & Rehabilitation of WyomingWyoming, MI, CCN 235441 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jul 1, 2025
Sep 9, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 12

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": "1248220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1295965499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5036 STONEHENGE DR",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490245727",
            "telephone_number": "269-716-3574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5036 STONEHENGE DR",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490245727",
            "telephone_number": "269-716-3574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELDT",
        "first_name": "MIRIAM",
        "middle_name": "YVONNE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-22",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301095330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIRIAM",
            "last_name": "GIBSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portage, MI

Sources for this page

Verify at the official NPI Registry.