Stacey A Pniewski, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5601005529 Issued in MI

Practice address

1959 E Paris Ave SE
Grand Rapids, MI 49546-6272

Phone

(616) 808-2695

Fax

(616) 808-2697

NPI assigned

Jun 15, 2009

Sex

Female

Sole proprietor

No

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.

• Age Management of West Michigan PC

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1558700625

  MI

  Medicare reassignment Care Compare group
• Ahsl Holland Operations, LLC

  • Assisted Living Facility
  • Holland, MI
  • NPI 1770987349
  NPD (past)
• Platinum Living LLC

  • Assisted Living Facility
  • Hudsonville, MI
  • NPI 1588094775
  NPD (past)

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

• Pennock Hospital

  • Critical Access Hospital
  • Hastings, MI
  • NPI 1932695525

  Hospital

  Care Compare affiliation
• Spectrum Health Hospitals

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

  Hospital

  Care Compare affiliation

Specialty

Physician Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Age Management of West Michigan PC 23 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

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

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

Interoperability endpoints

• Direct secure messaging: spniewski102575@epic00.corewelldirect.org

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 11, 2014.

{
    "created_epoch": "1245024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418256000000",
    "number": "1770710998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1959 E PARIS AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466272",
            "telephone_number": "616-808-2695",
            "fax_number": "616-808-2697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 E PARIS AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466272",
            "telephone_number": "616-808-2695",
            "fax_number": "616-808-2697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PNIEWSKI",
        "first_name": "STACEY",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-15",
        "last_updated": "2014-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601005529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Patricia Plominski, PA-C
• Joshua Plonka
• Courtney Ann Plouff, WHNP-BC
• Shane William Pluger, D.C.
• Megan Pluymert, LLMSW
• James Pochert, MD
• Mary Claire Podein, P.T.
• Amy Podgorica
• Zamir Gani Podgorica, M.D.
• Podiatry West Senior Foot Care Services PLLC

• All providers in Grand Rapids, MI
• Medical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 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.
• 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.