Individual provider Active NPI

Amber Lynn Pollak, PA-C

  • Physician Assistant
  • Wyoming, MI
National Provider Identifier
1851575294
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
5900 Byron Center Ave SW
Wyoming, MI 49519-9606
Phone
(616) 252-7200
NPI assigned
Dec 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 MI Primary

Addresses

Primary practice location

5900 Byron Center Ave SW
Wyoming, MI 49519-9606

Mailing address

5900 Byron Center Ave SW
Medical Administration
Wyoming, MI 49519-9606
Phone (616) 252-3243

Other practice location 1

100 Michigan St NE
Suite 4297
Grand Rapids, MI 49503-2560
Phone (616) 267-7104

Other practice location 2

100 Michigan St NE
Suite 4297
Grand Rapids, MI 49503-2560
Phone (616) 267-7104

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
I20080521000121 MI Practitioner - Physician Assistant 6507935269 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metropolitan HospitalGroup PAC ID 5597651836, 421 clinicians

Practice addresses (Care Compare)

5900 Byron Ctr Ave
Wyoming, MI 49519-9606

5900 Byron Ctr Ave SW
Wyoming, MI 49519-9606
Phone (616) 252-3243

5900 Byron Ctr Swave
Wyoming, MI 49519-9606
Phone (616) 252-7200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Hospital CurrentSince Oct 30, 2017 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jan 1, 2011 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jan 1, 2011 Accepting new patients
Michigan Medical Patient Care Past Accepting new patients
Metropolitan Hospital Past Accepting new patients
Michigan Medical Patient Care Past Accepting new patients

Locations

100 Michigan St NE
Ste 4297
Grand Rapids, MI 49503
Phone (616) 267-7900

4085 Burton St SE
Ste 200
Grand Rapids, MI 49546

3322 Beltline Ct NE
Grand Rapids, MI 49525
Phone (616) 226-2669

4100 Lake Dr SE
Ste 202
Grand Rapids, MI 49546
Phone (616) 974-4400

2750 E Beltline Ave NE
Grand Rapids, MI 49525
Phone (616) 267-7015

25 Michigan St NE
Ste 6100
Grand Rapids, MI 49503
Phone (616) 267-7900

3232 N Wellness Dr
Holland, MI 49424
Phone (616) 494-4250

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

5900 Byron Center Ave SW
Wyoming, MI 49519
Phone (616) 252-3243

2122 Health Dr SW
Wyoming, MI 49519
Phone (616) 252-5950

5950 Metro Way SW
Wyoming, MI 49519
Phone (616) 252-8100

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1198108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1851575294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 BYRON CENTER AVE SW",
            "address_2": "MEDICAL ADMINISTRATION",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199606",
            "telephone_number": "616-252-3243",
            "fax_number": "616-252-0260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 BYRON CENTER AVE SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199606",
            "telephone_number": "616-252-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Michigan St NE",
            "address_2": "Suite 4297",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495032560",
            "country_code": "US",
            "telephone_number": "616-267-7104",
            "fax_number": "616-267-7594",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Michigan St NE",
            "address_2": "Suite 4297",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495032560",
            "country_code": "US",
            "telephone_number": "616-267-7104",
            "fax_number": "616-267-7594",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLLAK",
        "first_name": "AMBER",
        "middle_name": "LYNN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-20",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

Verify at the official NPI Registry.