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SEAN M CUNNINGHAM DO
NPI 1023469590
Family Medicine in West Olive, MI

Active since June 27, 2016PECOS EnrolledAccepts Medicare Assignment
15151 STANTON ST, WEST OLIVE, MI 49460(616) 685-1950(231) 727-5223 Get Directions Write a Review

NPPES record last updated: December 31, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 31, 2021, Jun 27, 2016 (2 updates tracked since 2016).

About Sean M Cunningham Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SEAN M CUNNINGHAM DO (NPI 1023469590) is an individual family medicine provider in West Olive, Michigan, licensed in Michigan (5101022669) and active in the NPI registry since June 2016. He is enrolled in Medicare PECOS, is affiliated with Spectrum Health, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1023469590
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameSEAN M CUNNINGHAMCredential: DO
Location Address15151 STANTON STWest Olive, MI 49460-8543
Mailing Address15151 Stanton StWest Olive, MI 49460-8543 · (616) 685-1950 · Fax (616) 685-1980
Phone(616) 685-1950
Fax(231) 727-5223
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateJune 27, 2016
Last NPPES UpdateDecember 31, 20212 updates tracked since enumeration
NPPES CertifiedDecember 31, 2021
✔ NPI 1023469590 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MI · 5101022669
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
15151 STANTON ST, West Olive, MI 49460
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Priority Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Sean M Cunningham Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8527394055
PECOS Enrollment IDI20190722002921
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
147 services72 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
52 services52 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
35 services23 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
17 services17 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Spectrum Health

Acute Care Hospitals · Grand Rapids, MI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230038
Location100 Michigan St NEGrand Rapids, MI 49503 · Kent County
Emergency services Birthing friendly

Trinity Health Muskegon Hospital

Acute Care Hospitals · Muskegon, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230066
Location1500 E Sherman BlvdMuskegon, MI 49441 · Muskegon County
Emergency services Birthing friendly

Holland Community Hospital

Acute Care Hospitals · Holland, MI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230072
Location602 Michigan AveHolland, MI 49423 · Ottawa County
Emergency services Birthing friendly

Trinity Health Grand Haven Hospital

Acute Care Hospitals · Grand Haven, MI
3/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number230174
Location1309 Sheldon RdGrand Haven, MI 49417 · Ottawa County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49460 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.74 typical visit price
range $54.34 – $166.68
Typical copayment $21.18 (range $13.58 – $41.67)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.09 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
1 supplier12 claims12 services$169.80 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JACK RICHARD ROOSSIEN JR. M.D.
Family Medicine
15151 STANTON ST, SUITE A
WEST OLIVE, MI 49460
Ottawa County (616) 296-1020
PHYSIOTHERAPY ASSOCIATES INC
Clinic/Center (Physical Therapy)
15151 STANTON ST, STE B
WEST OLIVE, MI 49460
Ottawa County (616) 844-1290
MERCY HEALTH PARTNERS
Clinic/Center (Rural Health)
15151 STANTON ST
WEST OLIVE, MI 49460
Ottawa County (616) 685-1950
LINDSEY ANN ROOSSIEN PA-C
Family Medicine (Adult Medicine)
15151 STANTON ST
WEST OLIVE, MI 49460
Ottawa County (616) 296-1020
STANTON CROSSINGS PHYSICAL THERAPY LLC
Physical Therapist
15151 STANTON ST, SUITE B
WEST OLIVE, MI 49460
Ottawa County (616) 296-9235
JACK R. ROOSSIEN JR., M.D.P.C.
Family Medicine
15151 STANTON ST, SUITE A
WEST OLIVE, MI 49460
Ottawa County (616) 296-1020
MRS. CARLY ANN GILBERT FNP-C
Nurse Practitioner (Family)
15151 STANTON ST
WEST OLIVE, MI 49460
Ottawa County (616) 685-1950

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sean Cunningham's NPI number?

The NPI number for Sean Cunningham is 1023469590. It was assigned to this individual provider in the NPPES registry on June 27, 2016.

Where is Sean Cunningham located?

Sean Cunningham practices at 15151 Stanton St, West Olive, MI 49460. The listed phone number is (616) 685-1950.

What is Sean Cunningham's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Sean Cunningham enrolled in Medicare?

Yes. Sean Cunningham is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Sean Cunningham accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company and Priority Health list Sean Cunningham as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Sean Cunningham affiliated with any hospitals?

According to CMS data, Sean Cunningham is affiliated with Spectrum Health, Trinity Health Muskegon Hospital, Holland Community Hospital and Trinity Health Grand Haven Hospital.

When was this NPI record last updated?

The NPPES record for Sean Cunningham was last updated on December 31, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.