Address Healthcare Of Michigan Pllc is a medicare enrolled "Internal Medicine" provider in Grand Rapids, Michigan. Their current practice location is
600 Monroe Avenue Nw, Ste 104, Grand Rapids, Michigan. You can reach out to their office (for appointments etc.) via phone at
(616) 366-4234.
Address Healthcare Of Michigan Pllc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Address Healthcare Of Michigan Pllc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1043075294.
Healthcare Provider's Profile
| Full Name | Address Healthcare Of Michigan Pllc |
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| Type | Facility |
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| Speciality | Internal Medicine |
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| Location | 600 Monroe Avenue Nw, Grand Rapids, Michigan |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1043075294
- Provider Enumeration Date: 02/16/2024
- Last Update Date: 02/16/2024
Medicare PECOS Information:
- PECOS PAC ID: 5395287924
- Enrollment ID: O20240611000362
Medical Identifiers
Medical identifiers for Address Healthcare Of Michigan Pllc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1043075294 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 152W00000X | Optometrist | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 207RH0002X | Internal Medicine - Hospice And Palliative Medicine | (* (Not Available)) | Secondary |
| 2084P0805X | Psychiatry & Neurology - Geriatric Psychiatry | (* (Not Available)) | Secondary |
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | (* (Not Available)) | Secondary |
| 363LA2200X | Nurse Practitioner - Adult Health | (* (Not Available)) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Address Healthcare Of Michigan Pllc acts as a billing entity for following providers:
| Provider Name | Angela Kuklewski |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1578941571
PECOS PAC ID: 5698088334
Enrollment ID: I20150723008369 |
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| Provider Name | Hilary J Cooper |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1710469366
PECOS PAC ID: 4486075520
Enrollment ID: I20200528001394 |
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| Provider Name | Mohamed A. Mohamed |
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| Provider Type | Practitioner - General Practice |
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| Provider Identifiers | NPI Number: 1972180131
PECOS PAC ID: 0143666966
Enrollment ID: I20240314001873 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Address Healthcare Of Michigan Pllc is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Address Healthcare Of Michigan Pllc
6804 Cecelia Drive,
New Port Richey, FL 34653
Ph: (616) 366-4234 | Address Healthcare Of Michigan Pllc
600 Monroe Avenue Nw, Ste 104,
Grand Rapids, MI 49503-1470
Ph: (616) 366-4234 |
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