Gregory James Niedzwiecki, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601005718 Issued in MI

Practice address

1215 E Michigan Ave
C/O Emergency Department
Lansing, MI 48912-1811

Phone

(517) 364-1000

NPI assigned

May 3, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Edward W. Sparrow Hospital Association

  • Pediatrics Physician
  • Lansing, MI
  • NPI 1831139088
  Medicare reassignment
• Grand River Emergency Medical Group PLC

  • Emergency Medicine Physician
  • Grand Rapids, MI
  • NPI 1114929353
  Medicare reassignment
• Vituity - Michigan Em PC

  • Emergency Medicine Physician
  • Lansing, MI
  • NPI 1144892332
  Medicare reassignment
• Edward W Sparrow Hospital Association

  • Adult Health Nurse Practitioner
  • Lansing, MI
  • NPI 1265220438
  NPD
• Edward W Sparrow Hospital Association

  • Internal Medicine Physician
  • Lansing, MI
  • NPI 1538596440
  NPD
• Medical Observation Services, PLLC

  • Emergency Medicine Physician
  • Lansing, MI
  • NPI 1346503158
  NPD (past)

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

{
    "created_epoch": "1272844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418860800000",
    "number": "1720305592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 E MICHIGAN AVE",
            "address_2": "C/O EMERGENCY DEPARTMENT",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121811",
            "telephone_number": "616-364-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 E MICHIGAN AVE",
            "address_2": "C/O EMERGENCY DEPARTMENT",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121811",
            "telephone_number": "517-364-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEDZWIECKI",
        "first_name": "GREGORY",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-03",
        "last_updated": "2014-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146M00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Intermediate",
            "state": "MI",
            "license": "3202006021",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601005718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron Nichols, MD
• Sue Nicholson, CSW
• Amelia Nickel
• Shamiera Nickens
• Riley Caudill Nickerson, LMSW
• Tessa Rose Nielsen
• Reena Chantal Niemann
• Anish Nimmagadda
• Cynthia Sue Nixon
• Niyo Capital Group LLC

• Physician Assistant in Lansing, MI
• Providers in Lansing, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.