Individual provider Active NPI

Amanda Leigh Lumbert, PA-C

  • Physician Assistant
  • Grand Rapids, MI
National Provider Identifier
1710793286
Registry record updated May 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601012909 Issued in MI
Practice address
235 Wealthy St SE Ste 100
Grand Rapids, MI 49503-5229
Phone
(616) 840-8224
Fax
(616) 840-9690
NPI assigned
Dec 9, 2024
Last updated
May 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2026

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 5601012909 MI Primary

Addresses

Primary practice location

235 Wealthy St SE Ste 100
Grand Rapids, MI 49503-5229

Mailing address

235 Wealthy St SE Ste 100
Grand Rapids, MI 49503-5229
Phone (616) 840-8224

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
I20250318000846 MI Practitioner - Physician Assistant 3173045309 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

235 Wealthy St SE
Grand Rapids, MI 49503-5229
Phone (616) 840-8000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Free Bed Rehabilitation Hospital CurrentSince Jan 12, 2026 Accepting new patients
Cancer & Hematology Centers of Western Mi, P.C. CurrentSince Feb 17, 2025 Accepting new patients
Mary Free Bed Rehabilitation Hospital CurrentSince Jan 12, 2026 Accepting new patients
Cancer & Hematology Centers of Western Mi, P.C. Past Accepting new patients

Locations

235 Wealthy St SE
Grand Rapids, MI 49503
Phone (616) 242-0422

235 Wealthy St SE
Ste 100
Grand Rapids, MI 49503
Phone (616) 493-9724

5800 Foremost Dr SE
Ste 100
Grand Rapids, MI 49546
Phone (616) 954-5554

12460 Riley St
Holland, MI 49424
Phone (616) 399-1308

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1733702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778198400000",
    "number": "1710793286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 WEALTHY ST SE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495035229",
            "telephone_number": "616-840-8224",
            "fax_number": "616-840-9690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 WEALTHY ST SE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495035229",
            "telephone_number": "616-840-8224",
            "fax_number": "616-840-9690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUMBERT",
        "first_name": "AMANDA",
        "middle_name": "LEIGH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-09",
        "last_updated": "2026-05-08",
        "certification_date": "2026-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601012909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.