Dakota K Degroot, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601011875 Issued in MI

Practice address

3850 Glenkerry CT
Portage, MI 49024-0700

Phone

(269) 327-7200

Fax

(269) 327-9272

NPI assigned

Sep 7, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Western Michigan Un Homer Stryker School of Med, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

West Shore Otolaryngology PCGroup PAC ID 4284998154, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Health Muskegon Hospital Hospital, Muskegon, MI, CCN 230066
• Mercy Health Lakeshore Campus Hospital, Shelby, MI, CCN 231320

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

• West Shore Otolaryngology PC

  dba West Shore ENT & Allergy Farr Rd

  • Multi-Specialty Clinic/Center
  • Norton Shores, MI
  • NPI 1548764426
  Medicare reassignment Care Compare group NPD (past)
• Three Rivers Health System, Inc

  dba Three Rivers Health Family Care White Pigeon

  • Rural Health Clinic/Center
  • White Pigeon, MI
  • NPI 1720350903
  Medicare reassignment
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  MI

  Medicare reassignment
• Three Rivers Health System, Inc

  dba Three Rivers Health Surgical Services

  • Surgery Physician
  • Three Rivers, MI
  • NPI 1063784247
  NPD
• Three Rivers Health System, Inc

  dba Three Rivers Health Infectious Disease

  • Infectious Disease Physician
  • Three Rivers, MI
  • NPI 1346874070
  NPD
• West Shore Otolaryngology PC

  dba West Shore ENT & Allergy Seminole Rd

  • Multi-Specialty Clinic/Center
  • Norton Shores, MI
  • NPI 1639674435
  NPD

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

• Mercy Health Partners

  dba MHP - Lakeshore Campus

  • Critical Access Hospital
  • Shelby, MI
  • NPI 1285662981
  Care Compare affiliation
• Mercy Health Partners

  dba Mercy Health Muskegon

  • General Acute Care Hospital
  • Muskegon, MI
  • NPI 1831132133
  Care Compare affiliation

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

{
    "created_epoch": "1694044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1790561546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR STE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 GLENKERRY CT",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490240700",
            "telephone_number": "269-327-7200",
            "fax_number": "269-327-9272"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12905 76th Ave",
            "address_purpose": "LOCATION",
            "city": "Allendale",
            "state": "MI",
            "postal_code": "494019747",
            "country_code": "US",
            "telephone_number": "616-375-5495",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEGROOT",
        "first_name": "DAKOTA",
        "middle_name": "K",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-07",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601011875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790561546",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2024; 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.