Katherine Mamo, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704330439 Issued in MI

Practice address

6200 Pine Hollow Dr Ste 400
East Lansing, MI 48823-9224

Phone

(517) 339-1676

NPI assigned

Jan 7, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Katherine Bursma Former name

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

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pine Hollow Partner LLCGroup PAC ID 5092002360, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Edward W Sparrow Hospital Hospital, Lansing, MI, CCN 230230
• University of Michigan Health - Sparrow Eaton Hospital, Charlotte, MI, CCN 231327

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: katherine.bursma.p1@direct.pinehollow.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Pine Hollow Partner LLC

  • Nurse Practitioner
  • East Lansing, MI
  • NPI 1275984700
  Medicare reassignment Care Compare group NPD

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

• Edward W Sparrow Hospital Association

  dba University of Michigan Health-Sparrow Lansing

  • General Acute Care Hospital
  • Lansing, MI
  • NPI 1073588711
  Care Compare affiliation
• Edward W Sparrow Hospital Association

  dba Thoracic Cardiovascular Institute

  • General Acute Care Hospital
  • Lansing, MI
  • NPI 1760710719
  Care Compare affiliation
• Sparrow Eaton Hospital

  dba University of Michigan Health-Sparrow Charlotte Orthopedics

  • Orthopaedic Surgery Physician
  • Charlotte, MI
  • NPI 1043419427

  Hospital

  Care Compare affiliation
• Sparrow Eaton Hospital

  dba University of Michigan Health-Sparrow

  • Ambulance
  • Charlotte, MI
  • NPI 1093742249

  Hospital

  Care Compare affiliation
• Sparrow Eaton Hospital

  dba University of Michigan Health-Sparrow Eaton

  • Critical Access Hospital
  • Charlotte, MI
  • NPI 1942254529
  Care Compare affiliation

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

{
    "created_epoch": "1641513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1679234934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 PINE HOLLOW DR STE 400",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488239224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 PINE HOLLOW DR STE 400",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488239224",
            "telephone_number": "517-339-1676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMO",
        "first_name": "KATHERINE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-07",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704330439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "BURSMA",
            "prefix": "MRS.",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Faith Mallory
• Mary Ann Malosh, BS,WHED
• Daniel Matthew Malsheske, PA
• Elizabeth C Malsheske, PA-C
• Oktai Mamedov, M.D.
• Ramy Mana, PHARMD
• Ryley Paul Mancine, DO
• Joseph Mandwee
• Melissa Anne Manninen, PH.D.
• Manual Physical Therapy Specialists, LLC

• Nurse Practitioner in East Lansing, MI
• Providers in East Lansing, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; 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.