Individual provider Active NPI

Jennifer Nicole Bienz, PA-C

  • Physician Assistant
  • Hudsonville, MI
National Provider Identifier
1306295936
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601007835 Issued in MI
Practice address
3440 Chicago Dr Ste 105
Hudsonville, MI 49426-1419
Phone
(616) 796-9560
NPI assigned
Jun 4, 2016
Last updated
Jan 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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 5601007835 MI Primary

Addresses

Primary practice location

3440 Chicago Dr Ste 105
Hudsonville, MI 49426-1419

Mailing address

3440 Chicago Dr Ste 105
Hudsonville, MI 49426-1419
Phone (616) 796-9560

Other names 1

  • Jennifer Nicole Gateley Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160706000775 WA Practitioner - Physician Assistant 5991097339 Reassigns benefits to 1 organization
I20231104000667 MI Practitioner - Physician Assistant 5991097339 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holland Community HospitalGroup PAC ID 0446157291, 174 clinicians

Practice addresses (Care Compare)

3440 Chicago Dr
Suite 105
Hudsonville, MI 49426-1427
Phone (616) 796-9560

577 Michigan Ave
Holland, MI 49423-4911

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Holland Community Hospital Physician Assistant CurrentSince Jan 6, 2025 Accepting new patients
Virginia Mason Medical Center CurrentSince Aug 11, 2016 Accepting new patients
Holland Community Hospital Physician Assistant CurrentSince Jan 6, 2025 Accepting new patients
Holland Community Hospital Past Accepting new patients

Locations

577 Michigan Ave
Ste 101
Holland, MI 49423
Phone (616) 393-2190

602 Michigan Ave
Holland, MI 49423
Phone (616) 394-3350

3440 Chicago Dr
Ste 105
Hudsonville, MI 49426
Phone (616) 267-7888

11800 NE 128th St
Ste 300
Kirkland, WA 98034
Phone (425) 814-5100

1100 9th Ave
Seattle, WA 98101
Phone (206) 223-6980

Interoperability endpoints

  • Direct secure messaging: jennifer.bienz@holland.eclinicaldirectplus.com

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 1

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": "1464998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1306295936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3440 CHICAGO DR STE 105",
            "city": "HUDSONVILLE",
            "state": "MI",
            "postal_code": "494261419",
            "telephone_number": "616-796-9560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 CHICAGO DR STE 105",
            "city": "HUDSONVILLE",
            "state": "MI",
            "postal_code": "494261419",
            "telephone_number": "616-796-9560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIENZ",
        "first_name": "JENNIFER",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-04",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "GATELEY",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hudsonville, MI

Sources for this page

Verify at the official NPI Registry.