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

Last updated

Dec 11, 2014By the provider in NPPES

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

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, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Age Management of West Michigan PCGroup PAC ID 2466686290, 23 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: spniewski102575@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Age Management of West Michigan PC

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

  dba Corewell Health Pennock Hospital

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

  dba Corewell Health Grand Rapids Hospital

  • 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": "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

• Medical Physician Assistant in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• 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.