NPIMap

Individual provider Active NPI

Meghan Marie Summey, PA-C

  • Physician Assistant
  • Grand Rapids, MI
National Provider Identifier
1891990701
Registry record updated Nov 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601005000 Issued in MI
Practice address
1925 Breton Rd SE
Grand Rapids, MI 49506-4810
Phone
(616) 252-4100
Fax
(616) 252-4953
NPI assigned
Jun 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2013

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 5601005000 MI Primary

Addresses

Primary practice location

1925 Breton Rd SE
Grand Rapids, MI 49506-4810

Mailing address

985 Gezon Pkwy SW
Attn: Teresa McNally
Wyoming, MI 49509-9563
Phone (616) 252-4655

Other identifiers 2

IdentifierTypeStateIssuer
1891990701MedicaidMI
5601005000OtherMISTATE LICENSE NUMBER

Other names 1

  • Miss Meghan Marie Bulger Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070809000700 MI Practitioner - Physician Assistant 9638260367 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

Practice addresses (Care Compare)

10047 Crossroad CT SE
Caledonia, MI 49316-7316
Phone (616) 685-8850

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601005000MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Health Saint Mary's Medical Group Physician Assistant CurrentSince Mar 3, 2014 Accepting new patients
Metropolitan Hospital CurrentSince Oct 5, 2009 Accepting new patients
Metropolitan Hospital CurrentSince Oct 5, 2009 Accepting new patients
Advantage Health Saint Mary's Medical Group Past Accepting new patients
Metropolitan Hospital Past Accepting new patients

Locations

2373 64th St SW
Ste 1300
Byron Center, MI 49315
Phone (616) 685-1350

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

1925 Breton Rd SE
Grand Rapids, MI 49506
Phone (616) 252-4100

985 Gezon Pkwy SW
Wyoming, MI 49509

781 36th St SE
Wyoming, MI 49548
Phone (616) 252-4100

Interoperability endpoints

  • Direct secure messaging: msummey44450@direct.trinity-health.org

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": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384473600000",
    "number": "1891990701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "985 GEZON PKWY SW",
            "address_2": "ATTN: TERESA MCNALLY",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495099563",
            "telephone_number": "616-252-4655",
            "fax_number": "616-252-0103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 BRETON RD SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495064810",
            "telephone_number": "616-252-4100",
            "fax_number": "616-252-4953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMEY",
        "first_name": "MEGHAN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-19",
        "last_updated": "2013-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601005000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891990701",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "5601005000",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGHAN",
            "last_name": "BULGER",
            "middle_name": "MARIE",
            "prefix": "MISS",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.