Ivana Nyirenda, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601009532 Issued in MI

Practice address

1717 Shaffer St Ste 108
Kalamazoo, MI 49048-1629

Phone

(269) 226-5967

NPI assigned

Sep 15, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ascension Medical Group PromedGroup PAC ID 7315856077, 255 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Borgess Medical Center Hospital, Kalamazoo, MI, CCN 230117
• Oaklawn Hospital Hospital, Marshall, MI, CCN 230217
• Three Rivers Health Hospital, Three Rivers, MI, CCN 230015
• Bronson Methodist Hospital Hospital, Kalamazoo, MI, CCN 230017
• Sturgis Hospital Hospital, Sturgis, MI, CCN 230779
• Beacon Plainwell Long-term care hospital, Plainwell, MI, CCN 232034

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Ascension Medical Group Promed

  • Family Medicine Physician
  • Portage, MI
  • NPI 1497709869

  Internal Medicine

  Medicare reassignment Care Compare group NPD (past)
• Ascension Medical Group Promed

  • Pediatrics Physician
  • Sturgis, MI
  • NPI 1013926997
  NPD
• Promed Healthcare

  • Rural Health Clinic/Center
  • Plainwell, MI
  • NPI 1487708830
  NPD

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

• Ascension Borgess Hospital

  • Long Term Care Hospital
  • Plainwell, MI
  • NPI 1154504892

  Long-term care hospital

  Care Compare affiliation
• Ascension Borgess Hospital

  • General Acute Care Hospital
  • Kalamazoo, MI
  • NPI 1568416311
  Care Compare affiliation
• Bronson Methodist Hospital

  • General Acute Care Hospital
  • Kalamazoo, MI
  • NPI 1831116441
  Care Compare affiliation
• Ella E. M. Brown Charitable Circle

  • General Acute Care Hospital
  • Marshall, MI
  • NPI 1861475360
  Care Compare affiliation
• Sturgis Hospital, Inc.

  • Rural Acute Care Hospital
  • Sturgis, MI
  • NPI 1598099699
  Care Compare affiliation
• Three Rivers Health System, Inc

  • General Acute Care Hospital
  • Three Rivers, MI
  • NPI 1568739423
  Care Compare affiliation

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

{
    "created_epoch": "1568505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1669022307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 SHAFFER ST STE 108",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481629",
            "telephone_number": "269-226-5967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 SHAFFER ST STE 108",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481629",
            "telephone_number": "269-226-5967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYIRENDA",
        "first_name": "IVANA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-15",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5601009532APP19",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601009532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ahmad Nusairat
• Theresa Marie Nutten, PHD
• Rebecca Berkowitz Nutting, LMSW
• Lyndsay Nuyen, LMSW
• Haley Nye
• Nyumbani Afc
• Nicole Nzioki
• Jane Louise O Grady, MFT LPC LLP
• Chanel O'Brien, DO
• Erin E O'Brien

• Physician Assistant in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.