Individual provider Active NPI

Scott M Tuinstra, PA

  • Surgical Physician Assistant
  • Grand Rapids, MI
National Provider Identifier
1568559086
Registry record updated Aug 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
5601003962 Issued in MI
Practice address
3350 Eagle Park Dr NE Ste 102
Grand Rapids, MI 49525-4570
Phone
(616) 454-3465
Fax
(616) 454-0954
NPI assigned
Oct 6, 2006
Last updated
Aug 20, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 5601003962 MI Primary

Addresses

Primary practice location

3350 Eagle Park Dr NE Ste 102
Grand Rapids, MI 49525-4570

Mailing address

3350 Eagle Park Dr NE Ste 102
Grand Rapids, MI 49525-4570
Phone (616) 454-3465

Other identifiers 4

IdentifierTypeStateIssuer
1407010792OtherMIBXMI
OD14869OtherMIGROUP PTAN - OAM
ST003962OtherMISTATE LICENSE
104721043MedicaidMI

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050623000907 MI Practitioner - Physician Assistant 1456396050 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Great Lakes Neurosurgical Associates PCGroup PAC ID 5890691182, 13 clinicians

Practice addresses (Care Compare)

3350 Eagle Park Dr NE
Suite 102
Grand Rapids, MI 49525-4570
Phone (616) 454-3465

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601003962MIMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Great Lakes Neurosurgical Associates, PC CurrentSince Mar 11, 2025 Accepting new patients
Neurosurgical Consultants LLP Surgical Past Accepting new patients
Neurosurgical Consultants LLP Surgical PastSince Apr 26, 2003 Accepting new patients

Locations

3350 Eagle Park Dr NE
Ste 102
Grand Rapids, MI 49525
Phone (616) 242-7042

3299 N Wellness Dr
Ste 240
Holland, MI 49424
Phone (616) 454-7910

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1568559086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 EAGLE PARK DR NE STE 102",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495254570",
            "telephone_number": "616-454-3465",
            "fax_number": "616-454-0954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 EAGLE PARK DR NE STE 102",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495254570",
            "telephone_number": "616-454-3465",
            "fax_number": "616-454-0954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUINSTRA",
        "first_name": "SCOTT",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MI",
            "license": "5601003962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BXMI",
            "identifier": "1407010792",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN - OAM",
            "identifier": "OD14869",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "ST003962",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104721043",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.