Danielle Otis, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5601007780 Issued in MI

Practice address

601 John St Ste M-124
Kalamazoo, MI 49007-5377

Phone

(269) 341-7500

NPI assigned

May 23, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Danielle Shouldice Former name

Electronic endpoints 1

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

Wayne State University School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bronson Methodist HospitalGroup PAC ID 0244148633, 721 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bronson Methodist Hospital Hospital, Kalamazoo, MI, CCN 230017
• Bronson Battle Creek Hospital Hospital, Battle Creek, MI, CCN 230075
• Bronson Lakeview Hospital Hospital, Paw Paw, MI, CCN 231332

Merit-based Incentive Payment System (MIPS)

Final score

86.43 of 100Reported as group

Quality

75.38

Promoting interoperability

100

Improvement activities

40

Cost

79.38

Merit-based Incentive Payment System (MIPS)

Final score

87.91 of 100Reported as group

Quality

83.03

Promoting interoperability

100

Improvement activities

40

Cost

76.65

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: direct@direct.bronsonhg.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.

• Bronson Methodist Hospital

  • Hospitalist Physician
  • Kalamazoo, MI
  • NPI 1417961137
  Medicare reassignment Care Compare group NPD
• Bronson Battle Creek Hospital

  • Internal Medicine Physician
  • Battle Creek, MI
  • NPI 1093119638
  Medicare reassignment NPD
• Southwestern Michigan Emergency Services, PC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Kalamazoo, MI
  • NPI 1013021310
  Medicare reassignment
• Diagnostic Pathology Services of Southwest Michigan PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Kalamazoo, MI
  • NPI 1912241597
  NPD
• Patholgy Services of Kalamazoo, PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Kalamazoo, MI
  • NPI 1548243595
  NPD

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

• Bronson Battle Creek Hospital

  • General Acute Care Hospital
  • Battle Creek, MI
  • NPI 1083644579
  Care Compare affiliation
• Bronson Lakeview Hospital

  • Critical Access Hospital
  • Paw Paw, MI
  • NPI 1962508259
  Care Compare affiliation
• Bronson Methodist Hospital

  • General Acute Care Hospital
  • Kalamazoo, MI
  • NPI 1831116441
  Care Compare affiliation

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

{
    "created_epoch": "1463961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1457708109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 22ND ST S",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490153007",
            "telephone_number": "269-579-3499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 JOHN ST STE M-124",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075377",
            "telephone_number": "269-341-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTIS",
        "first_name": "DANIELLE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-23",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601007780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DANIELLE",
            "last_name": "SHOULDICE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Kiley June Ostrowski, RN-BSN
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• Jessica Otten
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• Joshua James Ouding
• Justine Melodie Oudsema, PA-C

• Medical Physician Assistant in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Medical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.