NPIMap

Individual provider Active NPI

Connor Gemlick

  • Physician Assistant
  • Grand Rapids, MI
National Provider Identifier
1619589546
Registry record updated Mar 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601011084 Issued in MI
Practice address
1111 Leffingwell Ave NE
Grand Rapids, MI 49525-6406
Phone
(616) 459-7101
NPI assigned
Aug 21, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601011084 MI Primary

Addresses

Primary practice location

1111 Leffingwell Ave NE
Grand Rapids, MI 49525-6406

Mailing address

1111 Leffingwell Ave NE
Grand Rapids, MI 49525-6406
Phone (616) 459-7101

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address connor.gemlick.p1@direct.oam.nextgenshare.com Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220916000733 MI Practitioner - Physician Assistant 3971988684 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for Physical Rehabilitation IncGroup PAC ID 6901717768, 352 clinicians
Center for Physical Rehabilitation and Therapy LPGroup PAC ID 0941513303, 365 clinicians

Practice addresses (Care Compare)

1111 Leffingwell Ave NE
Grand Rapids, MI 49525-6406
Phone (616) 459-7101

5060 Cascade Rd
Suite a
Grand Rapids, MI 49546-3808

5060 Cascade Rd SE
Suite a
Grand Rapids, MI 49546-3808

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Associates of Grand Rapids, PC Physician Assistant CurrentSince Apr 1, 2023 Accepting new patients
Orthopaedic Associates of Grand Rapids PC CurrentSince Apr 1, 2023 Accepting new patients
Orthopaedic Associates of Grand Rapids PC Past Accepting new patients

Locations

1111 Leffingwell Ave NE
Grand Rapids, MI 49525
Phone 61645971011381

1111 Leffingwell Ave NE
Ste 100
Grand Rapids, MI 49525
Phone 61645971011381

2680 Leonard St NE
Grand Rapids, MI 49525
Phone (616) 224-1110

Interoperability endpoints

  • Direct secure messaging: connor.gemlick.p1@direct.oam.nextgenshare.com

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1597968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773619200000",
    "number": "1619589546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 LEFFINGWELL AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495256406",
            "telephone_number": "616-459-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 LEFFINGWELL AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495256406",
            "telephone_number": "616-459-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEMLICK",
        "first_name": "CONNOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-21",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601011084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "connor.gemlick.p1@direct.oam.nextgenshare.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1111 Leffingwell Ave NE",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495256406",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.