Rose Hulst, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601009818 Issued in MI

Practice address

230 W Oak St
Fremont, MI 49412-1526

Phone

(231) 924-4200

NPI assigned

Mar 3, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Rose Pankiewicz Former name

Electronic endpoints 4

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

Specialty

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Newaygo County General Hospital AssociationGroup PAC ID 4880503051, 64 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Corewell Health Gerber Hospital Hospital, Fremont, MI, CCN 231338
• Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rhulst242877@epic00.shdirect.org
• Direct secure messaging: bdean106620@epic00.shdirect.org
• Direct secure messaging: rhulst242877@epic00.corewelldirect.org

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.

• Newaygo County General Hospital Association

  • Hospitalist Physician
  • Fremont, MI
  • NPI 1750404927
  Medicare reassignment Care Compare group NPD
• Newaygo County General Hospital Association

  • Critical Access Hospital
  • Fremont, MI
  • NPI 1063836963
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Newaygo County General Hospital Association

  • Critical Access Hospital
  • Fremont, MI
  • NPI 1063836963
  Care Compare affiliation
• Pennock Hospital

  • Critical Access Hospital
  • Hastings, MI
  • NPI 1932695525
  Care Compare affiliation
• Spectrum Health Hospitals

  • General Acute Care Hospital
  • Grand Rapids, MI
  • NPI 1922090554
  Care Compare affiliation

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

{
    "created_epoch": "1583193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1720613490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 W OAK ST",
            "city": "FREMONT",
            "state": "MI",
            "postal_code": "494121526",
            "telephone_number": "231-924-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HULST",
        "first_name": "ROSE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-03",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601009818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bdean106620@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "230 W Oak St",
            "city": "Fremont",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494121526",
            "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": "230 W Oak St",
            "city": "Fremont",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494121526",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rhulst242877@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "230 W Oak St",
            "city": "Fremont",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494121526",
            "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": "230 W Oak St",
            "city": "Fremont",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494121526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ROSE",
            "last_name": "PANKIEWICZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Anna Holeman, L.M.T
• Brian S Hood, D.O.
• Heather Lynn Hopwood
• Christopher J. Hudson, M.D.
• Charles William Hughes
• Anna Hunt, RN, BSN, CDP, CADDCT
• Jeffrey B. Byland, O.D., P.C.
• Kelly Marie Jewell
• Douglas A. Johnson, M.D.
• Jordan Raymond Jones, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.