Individual provider Active NPI

Amy Lynn Hoffman, DO

  • Emergency Medicine Physician
  • Grand Haven, MI
National Provider Identifier
1508870197
Registry record updated Apr 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
5101014274 Issued in MI
Practice address
1309 Sheldon Rd
Grand Haven, MI 49417-2404
Phone
(866) 898-7139
Fax
(616) 975-9824
NPI assigned
Jul 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X O2823 KY
Emergency Medicine Physician 207P00000X 02003951A IN
Emergency Medicine Physician 207P00000X 5101014274 MI Primary

Addresses

Primary practice location

1309 Sheldon Rd
Grand Haven, MI 49417-2404

Mailing address

PO Box 673755
Detroit, MI 48267-3755
Phone (866) 898-7139

Other identifiers 2

IdentifierTypeStateIssuer
114984984MedicaidMI
AH014274OtherBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140521001586 IN Practitioner - Emergency Medicine 8820988835 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
02003951AINMDEmergency Medicine Physician
O2823KYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC Emergency Medicine CurrentSince May 1, 2022 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince May 1, 2022 Accepting new patients
Cep America LLC Emergency Medicine Current Accepting new patients
Acs Primary Care Physicians-Midwest Emergency Medicine Past Accepting new patients
Major Hospital Past Accepting new patients
Emergency Health Partners Grand Haven PLC Emergency Medicine Past Accepting new patients
Emergency Health Partners Muskegon Emergency Medicine Past Accepting new patients
Pere Marquette Emergency Physicians, PLC Emergency Medicine Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

2015 Jackson St
Anderson, IN 46016
Phone (765) 646-8243

801 N State St
Greenfield, IN 46140
Phone (317) 462-5544

1300 N Main St
Rushville, IN 46173
Phone (317) 802-3106

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1508870197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 673755",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482673755",
            "telephone_number": "866-898-7139",
            "fax_number": "616-975-9824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 SHELDON RD",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494172404",
            "telephone_number": "866-898-7139",
            "fax_number": "616-975-9824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFFMAN",
        "first_name": "AMY",
        "middle_name": "LYNN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "O2823",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "02003951A",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101014274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114984984",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "AH014274",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Haven, MI

Sources for this page

Verify at the official NPI Registry.