Active NPI
Jeneal M Duff, PA-C
- Medical Physician Assistant
- Byron Center, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 5601012103
- Practice address
- 2373 64TH St SW Ste 1300
Byron Center, MI 49315-7975 - Phone
- (872) 588-3000
- NPI assigned
- Mar 13, 2019
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 085.006970 | IL | |
| Medical Physician Assistant | 363AM0700X | 5601012103 | MI | Primary |
| Physician Assistant | 363A00000X | 085006970 | IL |
Addresses
Primary practice location
2373 64TH St SW Ste 1300
Byron Center, MI 49315-7975
Mailing address
2743 Olivia St NW
Grand Rapids, MI 49504-5894
Phone (317) 670-2912
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5601012103 | Other | MI | STATE LICENSE |
| 1159852 | Other | IL | SPECIALTY BOARDS |
| 5315244931 | Other | MI | CS LICENSE |
| 385005452 | Other | IL | CS LICENSE |
| 085006970 | Other | IL | STATE 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, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Center for Physical Rehabilitation Inc
Practice addresses (Care Compare)
10047 Crossroad CT SE
Caledonia, MI 49316-7316
Phone (616) 685-8850
5060 Cascade Rd
Grand Rapids, MI 49546-3808
5060 Cascade Rd SE
Grand Rapids, MI 49546-3808
Hospital & facility affiliations
- Mercy Health Saint Mary'S
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085006970 | IL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advantage Health/Saint Mary'S Medical Group | Current | Accepting new patients | |
| Advantage Health Saint Mary'S Medical Group | Physician Assistant | Current | Accepting new patients |
| Advantage Health Saint Mary'S Medical Group | Past | Accepting new patients |
Locations
2373 64th St SW
Ste 1300
Byron Center, MI 49315
Phone (616) 685-1350
10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850
Interoperability endpoints
- jduff3132609@direct.trinity-health.org
Organizations & group practices 5
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.
-
- Multi-Specialty Clinic/Center
- Grand Rapids, MI
- NPI 1376862151
-
- Physical Therapy Clinic/Center
- Grand Rapids, MI
- NPI 1902288863
-
- Orthopaedic Surgery Physician
- Byron Center, MI
- NPI 1003515008
Physician Assistant
-
- Clinic/Center
- Sparta, MI
- NPI 1760599906
-
- Multi-Specialty Clinic/Center
- Grand Rapids, MI
- NPI 1952340911
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Grand Rapids, MI
- NPI 1639111057
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705968000000",
"number": "1346709052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2743 OLIVIA ST NW",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495045894",
"telephone_number": "317-670-2912"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2373 64TH ST SW STE 1300",
"city": "BYRON CENTER",
"state": "MI",
"postal_code": "493157975",
"telephone_number": "872-588-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUFF",
"first_name": "JENEAL",
"middle_name": "M",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-13",
"last_updated": "2024-01-23",
"certification_date": "2024-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "IL",
"license": "085.006970",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "MI",
"license": "5601012103",
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IL",
"license": "085006970",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "5601012103",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SPECIALTY BOARDS",
"identifier": "1159852",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CS LICENSE",
"identifier": "5315244931",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CS LICENSE",
"identifier": "385005452",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "085006970",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Byron Center, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; 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.