Individual provider Active NPI

Marlee Jayne Bogema, FNP

  • Family Nurse Practitioner
  • Grand Rapids, MI
National Provider Identifier
1396398236
Registry record updated Mar 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704296160 Issued in MI
Practice address
250 Cherry St SE Ste 2200
Grand Rapids, MI 49503-4608
Phone
(616) 685-5600
NPI assigned
Jul 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704296160 MI Primary

Addresses

Primary practice location

250 Cherry St SE Ste 2200
Grand Rapids, MI 49503-4608

Mailing address

5800 Foremost Dr SE Ste 300
Grand Rapids, MI 49546-7062

Other names 1

  • Marlee Jayne Muilenburg Former name

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
I20191205001310 MI Practitioner - Nurse Practitioner 5395178305 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
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

15100 220TH Ave
Big Rapids, MI 49307-9248
Phone (231) 515-9410

710 Kenmoor Ave SE
Suite 200
Grand Rapids, MI 49546-2379
Phone (616) 389-1800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
96
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Hospitals CurrentSince Nov 30, 2020 Accepting new patients
Spectrum Health Hospitals CurrentSince Nov 30, 2020 Accepting new patients
Cancer & Hematology Centers of Western Mi, P.C. CurrentSince Oct 1, 2020 Accepting new patients

Locations

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

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

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

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

250 Cherry St SE
Ste 2200
Grand Rapids, MI 49503
Phone (616) 685-5600

5800 Foremost Dr SE
Ste 300
Grand Rapids, MI 49546
Phone (616) 389-1725

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

80 68th St SE
Kentwood, MI 49548
Phone (616) 391-8220

Interoperability endpoints

  • Direct secure messaging: mbogema103514@direct.covenanthealthcare.com

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1563494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1396398236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 FOREMOST DR SE STE 300",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 CHERRY ST SE STE 2200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034608",
            "telephone_number": "616-685-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGEMA",
        "first_name": "MARLEE",
        "middle_name": "JAYNE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-19",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704296160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARLEE",
            "last_name": "MUILENBURG",
            "middle_name": "JAYNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.