Individual provider Active NPI

Aaron Mestemaker, NP

  • Nurse Practitioner
  • Grand Rapids, MI
National Provider Identifier
1407631104
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704320789 Issued in MI
Practice address
3210 Eagle Run Dr NE
Grand Rapids, MI 49525-7051
Phone
(616) 456-8553
Fax
(616) 454-5371
NPI assigned
Aug 30, 2023
Last updated
Aug 30, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704320789 MI Primary

Addresses

Primary practice location

3210 Eagle Run Dr NE
Grand Rapids, MI 49525-7051

Mailing address

3210 Eagle Run Dr NE
Grand Rapids, MI 49525-7051
Phone (616) 456-8553

Other practice location 1

709 S Greenville West Dr
Greenville, MI 48838-3514
Phone (616) 754-9146

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
I20240104001331 MI Practitioner - Nurse Practitioner 0547611519 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
West Michigan Cardiology, PC CurrentSince Dec 13, 2023 Accepting new patients
West Michigan Cardiology, PC Nurse Practitioner CurrentSince Dec 13, 2023 Accepting new patients

Locations

3210 Eagle Run Dr NE
Grand Rapids, MI 49525
Phone (616) 301-7500

3210 Eagle Run Dr NE
Ste 100
Grand Rapids, MI 49525
Phone (616) 279-3725

709 S Greenville West Dr
Greenville, MI 48838
Phone (616) 754-3880

Interoperability endpoints

  • Direct secure messaging: amestemaker182323@epic00.corewelldirect.org

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1693353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1407631104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3210 EAGLE RUN DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495257051",
            "telephone_number": "616-456-8553",
            "fax_number": "616-454-5371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3210 EAGLE RUN DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495257051",
            "telephone_number": "616-456-8553",
            "fax_number": "616-454-5371"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "709 S Greenville West Dr",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "MI",
            "postal_code": "488383514",
            "country_code": "US",
            "telephone_number": "616-754-9146",
            "fax_number": "616-754-9152",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MESTEMAKER",
        "first_name": "AARON",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-30",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704320789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.