Individual provider Active NPI

Angela Dejonge Meraz

  • Social Worker
  • Grand Rapids, MI
National Provider Identifier
1841550985
Registry record updated May 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6803086314 Issued in MI
Practice address
1939 Division Ave S
Grand Rapids, MI 49507-2459
Phone
(616) 247-3815
Fax
(616) 245-0450
NPI assigned
May 23, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6803086314 MI Primary

Addresses

Primary practice location

1939 Division Ave S
Grand Rapids, MI 49507-2459

Mailing address

207 W 17TH St
Holland, MI 49423-4114
Phone (616) 247-3815

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150717000477 MI Practitioner - Clinical Social Worker 6709199938 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Intercare Community Health NetworkGroup PAC ID 9537061254, 18 clinicians

Practice addresses (Care Compare)

50 Industrial Dr
Bangor, MI 49013

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6803086314MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Intercare Community Health Network CurrentSince Jun 13, 2015 Accepting new patients
Intercare Community Health Network CurrentSince Jun 13, 2015 Accepting new patients

Locations

50 Industrial Park Rd
Bangor, MI 49013
Phone (269) 427-7937

308 Charles St
Bangor, MI 49013
Phone (269) 427-7967

870 Colfax Ave
Benton Harbor, MI 49022
Phone (269) 605-1277

800 M 139
Benton Harbor, MI 49022
Phone (269) 927-5400

7450 Hochberger Rd
Eau Claire, MI 49111
Phone (855) 869-6900

285 James St
Holland, MI 49424
Phone (616) 399-0200

538 Washington St
Otsego, MI 49078
Phone (269) 694-7873

5498 109th Ave
Pullman, MI 49450
Phone (269) 236-5021

Interoperability endpoints

  • Direct secure messaging: angela.dejongemeraz@ichn.eclinicaldirectplus.com

Organizations & group practices 2

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": "1337731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337731200000",
    "number": "1841550985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 W 17TH ST",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494234114",
            "telephone_number": "616-247-3815",
            "fax_number": "616-245-0450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1939 DIVISION AVE S",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495072459",
            "telephone_number": "616-247-3815",
            "fax_number": "616-245-0450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEJONGE MERAZ",
        "first_name": "ANGELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-23",
        "last_updated": "2012-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6803086314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.