Individual provider Active NPI

Alexandra Katherine Shields, PA

  • Physician Assistant
  • Kalamazoo, MI
National Provider Identifier
1700319647
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601008277 Issued in MI
Practice address
1722 Shaffer St
Kalamazoo, MI 49048-1633
Phone
(269) 343-1555
NPI assigned
Apr 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

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 5601008277 MI Primary

Addresses

Primary practice location

1722 Shaffer St
Kalamazoo, MI 49048-1633

Mailing address

1722 Shaffer St
Kalamazoo, MI 49048-1633
Phone (269) 343-1555

Other practice location 1

221 Michigan St NE Ste 300
Grand Rapids, MI 49503-2537
Phone (616) 391-9415

Other names 1

  • Alexandra Katherine Olds Former name

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
I20170823000365 MI Practitioner - Physician Assistant 0648542803 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spectrum Health Primary Care PartnersGroup PAC ID 4587568647, 2,283 clinicians

Practice addresses (Care Compare)

100 Michigan Ave NE
Grand Rapids, MI 49503-2560

100 Michigan St NE RM
280 Corewell Health Medical Group West
Grand Rapids, MI 49503-2560
Phone (616) 267-0115

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

Hospital & facility affiliations

  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group Promed CurrentSince Nov 16, 2022 Accepting new patients
Spectrum Health Primary Care Partners Current Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Aug 1, 2025 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Aug 1, 2025 Accepting new patients
Promed Healthcare CurrentSince Nov 16, 2022 Accepting new patients
Bronson Methodist Hospital Physician Assistant CurrentSince Sep 5, 2017 Accepting new patients
Ascension Medical Group Promed Past Accepting new patients

Locations

3035 Capital Ave SW
Battle Creek, MI 49015
Phone (269) 565-9100

221 Michigan St NE
Ste 300
Grand Rapids, MI 49503
Phone (616) 459-7258

100 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1680

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

1815 Henson Ave
Kalamazoo, MI 49048
Phone (269) 492-6502

1722 Shaffer St
Kalamazoo, MI 49048
Phone (269) 226-5600

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

215 E Mansion St
Marshall, MI 49068
Phone (269) 789-3940

7901 Angling Rd
Portage, MI 49024
Phone (269) 324-8405

Organizations & group practices 7

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 2

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": "1491523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1700319647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1722 SHAFFER ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481633",
            "telephone_number": "269-343-1555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1722 SHAFFER ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481633",
            "telephone_number": "269-343-1555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "221 Michigan St NE Ste 300",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495032537",
            "country_code": "US",
            "telephone_number": "616-391-9415",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "ALEXANDRA",
        "middle_name": "KATHERINE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-07",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXANDRA",
            "last_name": "OLDS",
            "middle_name": "KATHERINE",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.