Individual provider Active NPI

Michelle L Andary, DO

  • Physical Medicine & Rehabilitation Physician
  • Grand Rapids, MI
National Provider Identifier
1841938685
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
5151015815 Issued in MI
Practice address
235 Wealthy St SE
Grand Rapids, MI 49503-5247
Phone
(616) 840-8000
NPI assigned
May 23, 2022
Last updated
Aug 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 5151015815 MI
Physical Medicine & Rehabilitation Physician 208100000X 5151015815 MI Primary

Addresses

Primary practice location

235 Wealthy St SE
Grand Rapids, MI 49503-5247

Mailing address

205 N East Ave
Jackson, MI 49201-1753

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220705002736 MI Order and Referring Only - General PracticePractitioner - General Practice 1759761000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5151015815MIMDStudent in an Organized Health Care Education/Training Program

Interoperability endpoints

  • Direct secure messaging: mandary3185053@direct.trinity-health.org
  • Direct secure messaging: mandary791312@direct.hfhs.org

NPI Registry JSON

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

{
    "created_epoch": "1653264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1841938685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 N EAST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 WEALTHY ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495035247",
            "telephone_number": "616-840-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDARY",
        "first_name": "MICHELLE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-23",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "5151015815",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "5151015815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.