DR. RANDALL LEE HERREMA PSY.D.
NPI 1063569150
Psychologist - Clinical in Grand Rapids, MI
About Dr. Randall Lee Herrema Psy.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. RANDALL LEE HERREMA PSY.D. (NPI 1063569150) is an individual clinical provider in Grand Rapids, Michigan, licensed in Michigan (6301003721) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS and is a graduate of Other (1986).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Randall Lee Herrema Psy.d. 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.
Medicare Billing Reassignment
Medicare enrollment records show Randall Herrema reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Grand Rapids, MI 49512
- Reassigned Medicare billing, Michigan enrollment
- 12 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 49546 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
GRAND RAPIDS, MI 49546
GRAND RAPIDS, MI 49546
GRAND RAPIDS, MI 49546
GRAND RAPIDS, MI 49546
GRAND RAPIDS, MI 49546
GRAND RAPIDS, MI 49546
GRAND RAPIDS, MI 49546
GRAND RAPIDS, MI 49546
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 Randall Herrema's NPI number?
The NPI number for Randall Herrema is 1063569150. It was assigned to this individual provider in the NPPES registry on January 4, 2007.
Where is Randall Herrema located?
Randall Herrema practices at 3501 Lake Eastbrook Blvd SE Suite 280, Grand Rapids, MI 49546. The listed phone number is (616) 942-7331.
What is Randall Herrema's specialty?
The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.
Is Randall Herrema enrolled in Medicare?
Yes. Randall Herrema 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.
Which organization bills Medicare for Randall Herrema's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Randall Herrema reassigns Medicare benefits to Centennial Park Counseling, PLLC (Grand Rapids, MI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Randall Herrema's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Randall Herrema accept?
Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Oscar Insurance Company, Priority Health and UnitedHealthcare list Randall Herrema 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.
When was this NPI record last updated?
The NPPES record for Randall Herrema was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.
# Dr. Randall Lee Herrema, PSY.D. · NPI 1063569150
Clinical provider in Grand Rapids, Michigan. Individual provider, active in the CMS NPPES registry since January 4, 2007.
## Identity
- **NPI:** 1063569150 (Entity type: Individual)
- **Enumerated:** January 4, 2007
- **Primary specialty:** Psychologist - Clinical · taxonomy 103TC0700X
- **State license:** 6301003721 (Michigan)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 3501 LAKE EASTBROOK BLVD SE, SUITE 280, Grand Rapids, MI 49546-5938
- **Phone:** (616) 942-7331
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Centennial Park Counseling, PLLC (NPI 1689814469, Grand Rapids, MI), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1986
## Record status
- **NPPES last updated:** July 8, 2007
- **Other identifiers:** Medicare ID-Type Unspecified 0D14642 (MI)
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Source: [NPI Profile](https://npiprofile.com/npi/1063569150) · Data from the CMS NPPES public registry.