Andre Lane Pride, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601006117 Issued in MI

Practice address

300 North Ave
Battle Creek, MI 49017-3307

Phone

(269) 966-8000

Fax

(937) 619-4150

NPI assigned

Nov 16, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southwestern Michigan Emergency Services, PCGroup PAC ID 1456265891, 69 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bronson Battle Creek Hospital Hospital, Battle Creek, MI, CCN 230075

Merit-based Incentive Payment System (MIPS)

Final score

93.26 of 100Reported as group

Quality

79.63

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Southwestern Michigan Emergency Services, PC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Kalamazoo, MI
  • NPI 1013021310
  Medicare reassignment Care Compare group
• Bronson Methodist Hospital

  • Physician Assistant
  • Kalamazoo, MI
  • NPI 1013089820
  Medicare reassignment NPD
• Bronson Methodist Hospital

  • Hospitalist Physician
  • Kalamazoo, MI
  • NPI 1417961137

  Physician Assistant

  Medicare reassignment NPD
• Calhoun County Emergency Physicians PC

  • Emergency Medicine Physician
  • Battle Creek, MI
  • NPI 1952585465
  NPD (past)

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

• Bronson Battle Creek Hospital

  • General Acute Care Hospital
  • Battle Creek, MI
  • NPI 1083644579
  Care Compare affiliation

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

{
    "created_epoch": "1321401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338336000000",
    "number": "1881961027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 S KALAMAZOO MALL STE 204",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490074869",
            "telephone_number": "866-898-7139",
            "fax_number": "616-975-9827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 NORTH AVE",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490173307",
            "telephone_number": "269-966-8000",
            "fax_number": "937-619-4150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIDE",
        "first_name": "ANDRE",
        "middle_name": "LANE",
        "name_prefix": "Mr.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-16",
        "last_updated": "2012-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601006117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Premise Health of Michigan Medical, P.C
• Prevos Family Markets LLC
• Kathryn Mary Prevost, AU.D.
• Sarah Margaret Prevost, OTR/L
• Jamie Prewozniak
• Lila Mae Pride, L.M.S.W.
• Primary Care Psychology PLLC
• Ashley Pritt
• Linda L Proctor, PHARM D
• Katie Proeber, CTRS

• Physician Assistant in Battle Creek, MI
• Providers in Battle Creek, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2012; 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.