Individual provider Active NPI

Lisa Marie Teunissen, NP

  • Family Nurse Practitioner
  • Grand Rapids, MI
National Provider Identifier
1952966111
Registry record updated Sep 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704282290 Issued in MI
Practice address
145 Michigan St NE Ste 3100
Grand Rapids, MI 49503-2563
Phone
(616) 954-9800
NPI assigned
May 3, 2019
Last updated
Sep 1, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704282290 MI Primary

Addresses

Primary practice location

145 Michigan St NE Ste 3100
Grand Rapids, MI 49503-2563

Mailing address

5800 Foremost Dr SE Ste 300
Grand Rapids, MI 49546-7062

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
I20200902001984 MI Practitioner - Nurse Practitioner 3375960552 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

145 Michigan St NE
Suite 3100
Grand Rapids, MI 49503-2563
Phone (616) 954-9800

15100 220TH Ave
Big Rapids, MI 49307-9248
Phone (231) 515-9410

710 Kenmoor Ave SE
Suite 200
Grand Rapids, MI 49546-2379
Phone (616) 389-1800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
96
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704282290MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cancer & Hematology Centers of Western Mi, P.C. CurrentSince Sep 14, 2020 Accepting new patients

Locations

145 Michigan St NE
Ste 3100
Grand Rapids, MI 49503
Phone (616) 954-9800

5800 Foremost Dr SE
Ste 300
Grand Rapids, MI 49546
Phone (616) 389-1725

6425 Harvey St
Norton Shores, MI 49444
Phone (231) 737-3469

Interoperability endpoints

  • Direct secure messaging: lteunissen742560@direct.trinity-health.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1556841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598918400000",
    "number": "1952966111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 FOREMOST DR SE STE 300",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 MICHIGAN ST NE STE 3100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032563",
            "telephone_number": "616-954-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEUNISSEN",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-03",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704282290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.