Ashley F Dalstra, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601008624 Issued in MI

Practice address

4100 Lake Dr SE Ste 300
Grand Rapids, MI 49546

Phone

(616) 267-8860

NPI assigned

Jun 20, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ashley F Holland Former name

Medicare fee-for-service enrollment

Enrolled in MI, MD2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Spectrum Health Primary Care Partners

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1235188673
  Medicare reassignment NPD
• Cancer & Hematology Centers of Western Mi, P.C.

  • Specialist
  • Grand Rapids, MI
  • NPI 1528018389
  Medicare reassignment
• Emergency Service Associates PA

  • Emergency Medicine Physician
  • Salisbury, MD
  • NPI 1558340562
  Medicare reassignment
• Cancer & Hematology Centers of Western Mi, P.C.

  • Rheumatology Physician
  • Grand Rapids, MI
  • NPI 1467017434
  NPD
• Spectrum Health Primary Care Partners

  • Family Medicine Physician
  • Hudsonville, MI
  • NPI 1255821724

  Physician Assistant

  NPD
• Spectrum Health Primary Care Partners

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1689499667
  NPD
• Spectrum Health Hospitals

  • Hospitalist Physician
  • Grand Rapids, MI
  • NPI 1558407189
  NPD (past)

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

{
    "created_epoch": "1371686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535328000000",
    "number": "1932548294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 LAKE DR SE STE 300",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49546",
            "telephone_number": "616-267-8860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALSTRA",
        "first_name": "ASHLEY",
        "middle_name": "F",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-20",
        "last_updated": "2018-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLEY",
            "last_name": "HOLLAND",
            "middle_name": "F",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lindsay Dalman, LLPC
• David R Dalrymple, DDS, MD
• Susan Marie Dalrymple, ACNP
• Elise N Dalseth
• Makayla Dalson
• Kylene Dalton-Koons
• Emily Jane Dalton
• Jamie Lee Dalton, LMSW
• Julie Dalton
• Katie Elizabeth Dalton, NP

• Physician Assistant in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.