MARCELYN ANDERSON PA-C NPI 1801986914

NPI Information

NPI: 1801986914
Provider Name: MARCELYN ANDERSON, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Organization: APOGEE MEDICAL GROUP MICHIGAN PC

PECOS Registration: Yes

Address:
100 MICHIGAN ST NE
SUITE A721
GRAND RAPIDS, MI
ZIP 49503
Phone: (616) 391-3139
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Marcelyn Anderson, PA-C is a medical physician assistant in Grand Rapids, MI with 18 years of experience. Marcelyn Anderson, PA-C NPI is 1801986914. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

100 MICHIGAN ST NE
SUITE A721
GRAND RAPIDS, MI
ZIP 49503-560
Phone: (616) 391-3139
Fax: (616) 391-3044

The NPI 1801986914 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/13/2006 and was last updated on 2/24/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	2326-023	WISCONSIN	No
2	363AM0700X	Physician Assistant	Medical	5601006703	MICHIGAN	Yes
3	363AM0700X	Physician Assistant	Medical	085002748	ILLINOIS	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	43025800	MEDICAID	WISCONSIN
2	60828	OTHER	WISCONSIN	DEAN HEALTH INSURANCE
3	118606	OTHER	ILLINOIS	HEALTH ALLIANCE MEDICAL
4	1801986914	MEDICAID	MICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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