Individual provider Active NPI

Chastity Ann Delmoral, FNP

  • Family Nurse Practitioner
  • Grand Rapids, MI
National Provider Identifier
1649549072
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
336858 Issued in NY
Practice address
310 Lafayette Ave SE Ste 400
Grand Rapids, MI 49503-4693
Phone
(616) 752-6525
Fax
(616) 752-6525
NPI assigned
Dec 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 336858 NY Primary

Addresses

Primary practice location

310 Lafayette Ave SE Ste 400
Grand Rapids, MI 49503-4693

Mailing address

310 Lafayette Ave SE Ste 400
Grand Rapids, MI 49503-4693
Phone (616) 752-6525

Other practice location 1

1000 10th Ave
New York, NY 10019-1147
Phone (212) 523-6194

Other practice location 2

310 Lafayette Ave SE Ste 200
Grand Rapids, MI 49503-4693
Phone (616) 752-5890

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
I20210817003350 MI Practitioner - Nurse Practitioner 0749441343 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advantage Health/Saint Mary'S Medical GroupGroup PAC ID 4082807961, 499 clinicians

Practice addresses (Care Compare)

10047 Crossroad CT SE
Caledonia, MI 49316-7316
Phone (616) 685-8850

310 Lafayette Ave SE
Grand Rapids, MI 49503-4693

Hospital & facility affiliations

  • Mercy Health Saint Mary'S Hospital, Grand Rapids, MI, CCN 230059
  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
336858NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Grand River Gastroenterology PC CurrentSince Aug 1, 2021 Accepting new patients
Advantage Health/Saint Mary'S Medical Group Current Accepting new patients
Advantage Health Saint Mary'S Medical Group CurrentSince Apr 1, 2024 Accepting new patients
Advantage Health Saint Mary'S Medical Group CurrentSince Apr 1, 2024 Accepting new patients

Locations

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

310 Lafayette Ave SE
Ste 4
Grand Rapids, MI 49503
Phone (616) 752-6525

310 Lafayette Ave SE
Ste 40
Grand Rapids, MI 49503
Phone (616) 752-6525

310 Lafayette Ave SE
Ste 400
Grand Rapids, MI 49503
Phone (616) 752-6525

310 Lafayette Ave SE
Ste 200
Grand Rapids, MI 49503
Phone (616) 752-5890

Interoperability endpoints

  • Direct secure messaging: cdelmoral1232853@direct.trinity-health.org

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": "1323734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1649549072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 LAFAYETTE AVE SE STE 400",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034693",
            "telephone_number": "616-752-6525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 LAFAYETTE AVE SE STE 400",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034693",
            "telephone_number": "616-752-6525",
            "fax_number": "616-752-6525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 10th Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100191147",
            "country_code": "US",
            "telephone_number": "212-523-6194",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "310 Lafayette Ave SE Ste 200",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495034693",
            "country_code": "US",
            "telephone_number": "616-752-5890",
            "fax_number": "616-752-5855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DELMORAL",
        "first_name": "CHASTITY",
        "middle_name": "ANN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-13",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "336858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.