Individual provider Active NPI

Angela L Beezley, PAC

  • Physician Assistant
  • Norton Shores, MI
National Provider Identifier
1669424719
Registry record updated Mar 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601004502 Issued in MI
Practice address
6425 S. Harvey St.
Norton Shores, MI 49444-9739
Phone
(231) 737-3469
Fax
(231) 737-4548
NPI assigned
May 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2020

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 5601004502 MI Primary

Addresses

Primary practice location

6425 S. Harvey St.
Norton Shores, MI 49444-9739

Mailing address

5800 Foremost Dr SE Ste 300
Grand Rapids, MI 49546-7062
Phone (616) 954-9800

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
I20060614000034 MI Practitioner - Physician Assistant 4385656263 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12460 Riley St
Holland, MI 49424-8217
Phone (616) 399-6500

145 Michigan St NE
Suite 3100
Grand Rapids, MI 49503-2563
Phone (616) 954-9800

6425 S Harvey St
Norton Shores, MI 49444-9739
Phone (231) 737-3469

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
96
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601004502MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cancer & Hematology Centers of Western Mi, P.C. Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583884800000",
    "number": "1669424719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 FOREMOST DR SE STE 300",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467062",
            "telephone_number": "616-954-9800",
            "fax_number": "616-389-1766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6425 S. HARVEY ST.",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494449739",
            "telephone_number": "231-737-3469",
            "fax_number": "231-737-4548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEEZLEY",
        "first_name": "ANGELA",
        "middle_name": "L",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norton Shores, MI

Sources for this page

Verify at the official NPI Registry.