Active NPI
Michelle J Andersen, C.F.N.P.
- Family Nurse Practitioner
- Grand Rapids, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 4704217093
- Practice address
- 3264 N Evergreen Dr NE
Grand Rapids, MI 49525-9746 - Phone
- (616) 363-7272
- Fax
- (616) 361-5828
- NPI assigned
- Jun 30, 2006
- Last updated
- Apr 5, 2021
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4704217093 | MI | Primary |
Addresses
Primary practice location
3264 N Evergreen Dr NE
Grand Rapids, MI 49525-9746
Mailing address
3264 N Evergreen Dr NE
Grand Rapids, MI 49525-9746
Phone (616) 363-7272
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4466209 | Medicaid | MI | |
| 1639253784 | Medicaid | MI |
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
- Nurse Practitioner
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 Michigan Ave NE
Grand Rapids, MI 49503-2560
Phone (616) 363-7272
1104 Plymouth Ave SE
East Grand Rapids, MI 49506-6528
Phone (616) 363-7272
1987 Navaho TRL
Okemos, MI 48864-2721
Phone (616) 363-7272
25044 Hadlock Dr
Novi, MI 48374-2553
Phone (616) 363-7272
300 E Warwick Dr
Alma, MI 48801-1014
Phone (616) 363-7272
3881 Baulistrol Dr
Okemos, MI 48864-3392
Phone (616) 363-7272
4280 Redbud TRL
Williamston, MI 48895-9103
Phone (616) 363-7272
7250 Delta River Dr
Lansing, MI 48906-9074
Phone (616) 363-7272
844 Washington Ave
Holland, MI 49423-7195
Phone (616) 363-7272
Hospital & facility affiliations
- Mymichigan Medical Center Midland
- Mymichigan Medical Center Alma
- Mymichigan Medical Center Clare
- Mymichigan Medical Center Gladwin
- Mymichigan Medical Center West Branch
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.33 of 100
- Quality
- 91.31
- Improvement activities
- 40
- Cost
- 79.05
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.17 of 100
- Quality
- 91.34
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 82.58 of 100
- Quality
- 58.15
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 74.45
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Hospital | Family | Current | Accepting new patients |
| Memorial Hospital | Family | Current | Accepting new patients |
| Memorial Hospital | Current | Accepting new patients |
Locations
9000 Peet Rd
Chesaning, MI 48616
Phone (989) 720-2273
9099 E Lansing Rd
Ste B
Durand, MI 48429
Phone (989) 288-0400
208 N Shiawassee St
Owosso, MI 48867
Phone (989) 723-9796
826 W King St
Owosso, MI 48867
Phone (989) 720-2273
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Diagnostic Radiology Physician
- Grand Rapids, MI
- NPI 1740283324
-
dba Memorial Medical Associates
- General Practice Physician
- Owosso, MI
- NPI 1235160532
Family
-
dba Memorial Medical Associates
- General Practice Physician
- Owosso, MI
- NPI 1316008006
Family
-
dba Memorial Medical Associates
- Anesthesiology Physician
- Owosso, MI
- NPI 1659527737
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Alma, MI
- NPI 1023097771
-
- General Acute Care Hospital
- Clare, MI
- NPI 1568414589
-
- Critical Access Hospital
- Gladwin, MI
- NPI 1235248071
-
dba Family Practice Center
- General Acute Care Hospital
- Midland, MI
- NPI 1376973149
-
- General Acute Care Hospital
- Midland, MI
- NPI 1902841414
-
dba MidMichigan Medical Center- West Branch
- Family Medicine Physician
- West Branch, MI
- NPI 1518418292
Hospital
-
- General Acute Care Hospital
- West Branch, MI
- NPI 1538566765
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617580800000",
"number": "1386673853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3264 N EVERGREEN DR NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495259746",
"telephone_number": "616-363-7272",
"fax_number": "616-361-5828"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3264 N EVERGREEN DR NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495259746",
"telephone_number": "616-363-7272",
"fax_number": "616-361-5828"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSEN",
"first_name": "MICHELLE",
"middle_name": "J",
"name_prefix": "Miss",
"credential": "C.F.N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-30",
"last_updated": "2021-04-05",
"certification_date": "2021-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MI",
"license": "4704217093",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4466209",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1639253784",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2021; 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.