Andrew J Summerville, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601006750 Issued in MI

Practice address

1234 Napier Ave
Saint Joseph, MI 49085-2112

Phone

(269) 985-4632

Fax

(269) 985-4623

NPI assigned

Sep 12, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lakeland Medical PracticesGroup PAC ID 1658427042, 286 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lakeland Hospital, St Joseph Hospital, St Joseph, MI, CCN 230021
• Corewell Health Watervliet Hospital Hospital, Watervliet, MI, CCN 230078

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: asummerville1272224@epic00.corewelldirect.org

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.

• Lakeland Medical Practices

  • Internal Medicine Physician
  • Saint Joseph, MI
  • NPI 1538397120
  Medicare reassignment Care Compare group
• Lakeland Medical Practices

  • Internal Medicine Physician
  • Bridgman, MI
  • NPI 1568232247
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lakeland Community Hospital Watervliet

  • General Acute Care Hospital
  • Watervliet, MI
  • NPI 1700994845
  Care Compare affiliation
• Lakeland Hospitals at Niles and St Joseph, Inc

  • General Acute Care Hospital
  • Saint Joseph, MI
  • NPI 1134220031
  Care Compare affiliation

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

{
    "created_epoch": "1378944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422576000000",
    "number": "1447685102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 NAPIER AVE",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490852112",
            "telephone_number": "269-985-4632",
            "fax_number": "269-985-4623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 NAPIER AVE",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490852112",
            "telephone_number": "269-985-4632",
            "fax_number": "269-985-4623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMERVILLE",
        "first_name": "ANDREW",
        "middle_name": "J",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-12",
        "last_updated": "2015-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601006750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathlynn Jon Stull, D.C.
• Michael Joseph Stusick, D.D.S.P.C.
• Ted Sugimoto, MD
• Frederick Tobin Sulier, ED.D
• Devin Sullivan, DNP
• Hilda Sundberg
• Sunflower Family Services, Inc.
• Sunflower Therapy Centers Inc
• Marija Sunjkic Johnson, MA, LPC, NCC
• Sunset Coast Anesthesia Associates PC

• Physician Assistant in Saint Joseph, MI
• Providers in Saint Joseph, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2015; 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.

Verify at the official NPI Registry.