Active NPI
Karen Sue Timmermans, PA-C
- Physician Assistant
- Grand Rapids, MI
National Provider Identifier
1477534659
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 4601003685
- Practice address
- 2900 Bradford St NE
Grand Rapids, MI 49525-6427 - Phone
- (616) 885-5000
- Fax
- (616) 913-9025
- NPI assigned
- Nov 7, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 4601003685 | MI | Primary |
Addresses
Primary practice location
2900 Bradford St NE
Grand Rapids, MI 49525-6427
Mailing address
3264 N Evergreen Dr NE
Grand Rapids, MI 49525-9746
Phone (616) 885-5000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982921 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 90.33 of 100
- Quality
- 91.31
- Improvement activities
- 40
- Cost
- 79.05
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4601003685 | MI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West Michigan Heart | Physician Assistant | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Cardiovascular Disease Physician
- Grand Rapids, MI
- NPI 1174504021
Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1495152000000",
"number": "1477534659",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3264 N EVERGREEN DR NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495259746",
"telephone_number": "616-885-5000",
"fax_number": "616-913-9025"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2900 BRADFORD ST NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495256427",
"telephone_number": "616-885-5000",
"fax_number": "616-913-9025"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIMMERMANS",
"first_name": "KAREN",
"middle_name": "SUE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-07",
"last_updated": "2017-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "4601003685",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1982921",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.