Individual provider Active NPI

Justin Dale Reimink, P.A.

  • Medical Physician Assistant
  • Grand Rapids, MI
National Provider Identifier
1417266404
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5601005884 Issued in MI
Practice address
1000 E Paris Ave SE Ste 200
Grand Rapids, MI 49546-8383
Phone
(616) 685-3450
Fax
(616) 685-3454
NPI assigned
Sep 24, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5601005884 MI Primary

Addresses

Primary practice location

1000 E Paris Ave SE Ste 200
Grand Rapids, MI 49546-8383

Mailing address

PO Box 1847
Muskegon, MI 49443-1847
Phone (231) 672-2119

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
I20101020000866 MI Practitioner - Physician Assistant 3173716370 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1000 E Paris Ave SE
Suite 200
Grand Rapids, MI 49546-8383
Phone (616) 685-3450

10047 Crossroad CT SE
Caledonia, MI 49316-7316
Phone (616) 685-8850

220 Cherry St SE
Grand Rapids, MI 49503-4608
Phone (616) 685-5050

250 Cherry St SE
Grand Rapids, MI 49503-4608
Phone (616) 685-5600

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Promed Healthcare CurrentSince Feb 1, 2011 Accepting new patients
Advantage Health Saint Mary's Medical Group CurrentSince Nov 1, 2021 Accepting new patients
Advantage Health Saint Mary's Medical Group CurrentSince Nov 1, 2021 Accepting new patients

Locations

2373 64th St SW
Ste 1304
Byron Center, MI 49315
Phone (616) 685-3450

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

1000 East Paris Ave SE
Ste 200
Grand Rapids, MI 49546
Phone (616) 685-3450

310 Lafayette Ave SE
Ste 300
Grand Rapids, MI 49503
Phone (616) 685-3450

1722 Shaffer St
Ste 1
Kalamazoo, MI 49048
Phone (269) 381-3963

7901 Angling Rd
Portage, MI 49024
Phone (269) 324-8405

Interoperability endpoints

  • Direct secure messaging: jreimink1511911@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.

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": "1285286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1417266404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1847",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494431847",
            "telephone_number": "231-672-2119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E PARIS AVE SE STE 200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468383",
            "telephone_number": "616-685-3450",
            "fax_number": "616-685-3454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REIMINK",
        "first_name": "JUSTIN",
        "middle_name": "DALE",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-24",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601005884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.