Individual provider Active NPI

Katarina Ann Preisler, PA-C

  • Physician Assistant
  • Grand Rapids, MI
National Provider Identifier
1821859141
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601012188 Issued in MI
Practice address
1959 E Paris Ave SE
Grand Rapids, MI 49546-6272
Phone
(616) 808-2695
NPI assigned
Jan 23, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601012188 MI Primary

Addresses

Primary practice location

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

Mailing address

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

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240515000091 MI Practitioner - Physician Assistant 1951742493 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5601012188MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
State of Michigan Office of Financial Management CurrentSince Sep 8, 2024 Accepting new patients
State of Michigan Office of Financial Management CurrentSince Sep 8, 2024 Accepting new patients

Locations

2950 Monroe Ave NE
Grand Rapids, MI 49505
Phone (616) 364-5300

3000 Monroe Ave NE
Grand Rapids, MI 49505
Phone (616) 364-5295

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1705968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1821859141",
    "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"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREISLER",
        "first_name": "KATARINA",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-23",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601012188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.