Individual provider Active NPI

Jeremy Matthew Kaley, FNP

  • Family Nurse Practitioner
  • Muskegon, MI
National Provider Identifier
1972275832
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704349499 Issued in MI
Practice address
2009 Holton Rd
Muskegon, MI 49445-1578
Phone
(231) 291-8399
NPI assigned
Sep 29, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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 4704349499 MI Primary

Addresses

Primary practice location

2009 Holton Rd
Muskegon, MI 49445-1578

Mailing address

100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dsibary@med1services.com Direct

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
I20211005002302 MI Practitioner - Nurse Practitioner 4789082769 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Spectrum Health Primary Care PartnersGroup PAC ID 4587568647, 2,283 clinicians

Practice addresses (Care Compare)

2009 Holton Rd
Muskegon, MI 49445-1578
Phone (231) 291-8399

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

Hospital & facility affiliations

  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038
  • Corewell Health Gerber Hospital Hospital, Fremont, MI, CCN 231338
  • Trinity Health Muskegon Hospital Hospital, Muskegon, MI, CCN 230066

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners CurrentSince Dec 10, 2023 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Dec 10, 2023 Accepting new patients
Mercy Health Partners PastSince Sep 30, 2021 Accepting new patients

Locations

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

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

2009 Holton Rd
North Muskegon, MI 49445
Phone (231) 291-8020

Interoperability endpoints

  • Direct secure messaging: jkaley102614@epic00.corewelldirect.org
  • Direct secure messaging: jkaley1422777@direct.trinity-health.org

Organizations & group practices 3

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 4

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": "1632873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1972275832",
    "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": "2009 HOLTON RD",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494451578",
            "telephone_number": "231-291-8399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALEY",
        "first_name": "JEREMY",
        "middle_name": "MATTHEW",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-29",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704349499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dsibary@med1services.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1670 E Sherman Blvd",
            "city": "Muskegon",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494441863",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

Verify at the official NPI Registry.