NPIMap

Individual provider Active NPI

Michele Leigh Miles, PA-C

  • Physician Assistant
  • Lakeview, MI
National Provider Identifier
1700075181
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601005099 Issued in MI
Practice address
418 Washington St
Lakeview, MI 48850-7102
Phone
(989) 352-6474
Fax
(989) 352-8451
NPI assigned
Oct 22, 2007
Last updated
Feb 18, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

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 5601005099 MI Primary

Addresses

Primary practice location

418 Washington St
Lakeview, MI 48850-7102

Mailing address

100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560
Phone (616) 486-6790

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mmiles22525@epic00.shdirect.org
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080530000621 MI Practitioner - Physician Assistant 2466522602 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spectrum Health UnitedGroup PAC ID 6305836487, 90 clinicians

Practice addresses (Care Compare)

8650 Howard City Edmore Rd
Lakeview, MI 48850-9115

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health United CurrentSince Nov 4, 2013 Accepting new patients
Spectrum Health United CurrentSince Nov 4, 2013 Accepting new patients
West Michigan Rehab PLLC Past Accepting new patients

Locations

1227 W State St
Belding, MI 48809
Phone (616) 794-0800

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

1202 W Oak St
Greenville, MI 48838
Phone (616) 754-2944

418 Washington St
Lakeview, MI 48850
Phone (989) 352-6474

8650 Howard City Edmore Rd
Lakeview, MI 48850
Phone (989) 352-1800

Interoperability endpoints

  • Direct secure messaging: mmiles22525@epic00.corewelldirect.org
  • Direct secure messaging: mmiles22525@epic00.shdirect.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1193011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1700075181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC 845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-486-6790",
            "fax_number": "616-486-6702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 WASHINGTON ST",
            "city": "LAKEVIEW",
            "state": "MI",
            "postal_code": "488507102",
            "telephone_number": "989-352-6474",
            "fax_number": "989-352-8451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILES",
        "first_name": "MICHELE",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-22",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601005099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmiles22525@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "418 Washington St",
            "city": "Lakeview",
            "state": "MI",
            "country_code": "US",
            "postal_code": "488507102",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "418 Washington St",
            "city": "Lakeview",
            "state": "MI",
            "country_code": "US",
            "postal_code": "488507102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lakeview, MI

Sources for this page

Verify at the official NPI Registry.