Individual provider Active NPI

Kevin Hengeveld, DNP, RN, A-GNP

  • Nurse Practitioner
  • Grand Rapids, MI
National Provider Identifier
1699315747
Registry record updated May 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704207506 Issued in MI
Practice address
300 Lafayette Ave SE Ste 2045
Grand Rapids, MI 49503-4692
Phone
(616) 685-3098
Fax
(616) 685-3095
NPI assigned
Jan 7, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704207506 MI Primary

Addresses

Primary practice location

300 Lafayette Ave SE Ste 2045
Grand Rapids, MI 49503-4692

Mailing address

300 Lafayette Ave SE Ste 2045
Grand Rapids, MI 49503-4692
Phone (616) 685-3098

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
I20200325002032 MI Practitioner - Nurse Practitioner 0840628806 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health PartnersGroup PAC ID 1456430016, 65 clinicians
Advantage Health/Saint Mary'S Medical GroupGroup PAC ID 4082807961, 499 clinicians

Practice addresses (Care Compare)

125 E Southern Ave
Suite 120
Muskegon, MI 49442-5042
Phone (231) 672-4950

300 Lafayette Ave SE
Suite 2045
Grand Rapids, MI 49503-4692
Phone (616) 685-3098

Hospital & facility affiliations

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704207506MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Partners CurrentSince Sep 1, 2025 Accepting new patients
Mercy Health Partners CurrentSince Sep 1, 2025 Accepting new patients
Advantage Health Saint Mary'S Medical Group Nurse Practitioner CurrentSince Mar 6, 2020 Accepting new patients
Advantage Health Saint Mary'S Medical Group CurrentSince Mar 6, 2020 Accepting new patients
Advantage Health/Saint Mary'S Medical Group Current Accepting new patients

Locations

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

300 Lafayette Ave SE
Ste 2045
Grand Rapids, MI 49503
Phone (616) 685-3098

125 E Southern Ave
#120
Muskegon, MI 49442
Phone (231) 672-4950

71 Bevier St
Shelby, MI 49455
Phone (231) 861-2172

Organizations & group practices 5

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 1

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": "1578355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590537600000",
    "number": "1699315747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LAFAYETTE AVE SE STE 2045",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034692",
            "telephone_number": "616-685-3098",
            "fax_number": "616-685-3095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LAFAYETTE AVE SE STE 2045",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034692",
            "telephone_number": "616-685-3098",
            "fax_number": "616-685-3095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENGEVELD",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "DNP, RN, A-GNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-07",
        "last_updated": "2020-05-27",
        "certification_date": "2020-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704207506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.