Individual provider Active NPI

Ronald W Reusch, PA C

  • Physician Assistant
  • Grandville, MI
National Provider Identifier
1528085040
Registry record updated Apr 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601003430 Issued in MI
Practice address
3434 Rivertown Point CT SW
Grandville, MI 49418-3076
Phone
(616) 257-3344
Fax
(616) 257-1491
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 5601003430 MI
Physician Assistant 363A00000X 5601003430 MI Primary

Addresses

Primary practice location

3434 Rivertown Point CT SW
Grandville, MI 49418-3076

Mailing address

3434 Rivertown Point CT SW
Grandville, MI 49418-3076
Phone (616) 257-3344

Other practice location 1

750 E Beltline Ave NE Ste 301
Grand Rapids, MI 49525-6046
Phone (616) 942-9343

Other practice location 2

3290 N Wellness Dr Ste 240
Holland, MI 49424-7261
Phone (616) 395-9379

Other identifiers 1

IdentifierTypeStateIssuer
5601003430OtherMISTATE LICENSE #

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address RWR0316@westmiderm.emadirect.md Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601003430MIMDDermatology Physician

Interoperability endpoints

  • Direct secure messaging: rwr0316@westmiderm.emadirect.md

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1528085040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3434 RIVERTOWN POINT CT SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494183076",
            "telephone_number": "616-257-3344",
            "fax_number": "616-257-1491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3434 RIVERTOWN POINT CT SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494183076",
            "telephone_number": "616-257-3344",
            "fax_number": "616-257-1491"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 E Beltline Ave NE Ste 301",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495256046",
            "country_code": "US",
            "telephone_number": "616-942-9343",
            "fax_number": "616-942-2538",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3290 N Wellness Dr Ste 240",
            "address_purpose": "LOCATION",
            "city": "Holland",
            "state": "MI",
            "postal_code": "494247261",
            "country_code": "US",
            "telephone_number": "616-395-9379",
            "fax_number": "616-820-1457",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REUSCH",
        "first_name": "RONALD",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "5601003430",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601003430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE #",
            "identifier": "5601003430",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "RWR0316@westmiderm.emadirect.md",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "3434 Rivertown Point Ct SW",
            "city": "Grandville",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494183076",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grandville, MI

Sources for this page

Verify at the official NPI Registry.