MOLLY JANE TIESENGA APRN
NPI 1063977932
Nurse Practitioner - Adult Health in Grand Rapids, MI

Q: What is Molly Tiesenga's NPI number?

The NPI number for Molly Tiesenga is 1063977932. It was assigned to this individual provider in the NPPES registry on February 5, 2019.

Q: What is Molly Tiesenga's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Q: When was this NPI record last updated?

The NPPES record for Molly Tiesenga was last updated on April 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since February 05, 2019PECOS EnrolledAccepts Medicare Assignment

100/100

CMS Quality Rating

426 MICHIGAN ST NE, GRAND RAPIDS, MI 49503(616) 267-8338 Get Directions Write a Review

NPPES record last updated: April 3, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 3, 2024, Sep 6, 2022, Feb 28, 2019 and 1 more (4 updates tracked since 2019).

On this page

About Molly Jane Tiesenga Aprn NPPES

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

MOLLY JANE TIESENGA APRN (NPI 1063977932) is an individual adult health provider in Grand Rapids, Michigan, licensed in Oregon (10021431) and active in the NPI registry since February 2019. She is enrolled in Medicare PECOS, is affiliated with Legacy Good Samaritan Medical Center, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1063977932

Entity TypeIndividualFemale

Primary Taxonomy363LA2200X

Provider Legal NameMOLLY JANE TIESENGACredential: APRN

Location Address426 MICHIGAN ST NEGrand Rapids, MI 49503-5609

Mailing Address100 Michigan St Ne # Mc845Grand Rapids, MI 49503-2560

Phone(616) 267-8338

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateFebruary 5, 2019

Last NPPES UpdateApril 3, 20244 updates tracked since enumeration

NPPES CertifiedApril 3, 2024

✔ NPI 1063977932 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2200X

License✔ Licensed in OR · 10021431

Also ListedNurse Practitioner · GerontologyTaxonomy 363LG0600X · License 4704313324 (MI)

426 MICHIGAN ST NE, Grand Rapids, MI 49503

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., Regence BlueCross BlueShield of Oregon.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

Molly Jane Tiesenga Aprn 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 ID5395085872

PECOS Enrollment IDI20240417003370

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 2

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.

69 services66 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.

40 services40 patients

Hospital Affiliations CMS Care Compare 3

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

Legacy Good Samaritan Medical Center

Acute Care Hospitals · Portland, OR

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number380017

Location1015 NW 22nd Avenue, W121Portland, OR 97210 · Multnomah County

Emergency services Birthing friendly

Legacy Meridian Park Medical Center

Acute Care Hospitals · Tualatin, OR

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number380089

Location19300 SW 65th AvenueTualatin, OR 97062 · Washington County

Emergency services Birthing friendly

Legacy Salmon Creek Medical Center

Acute Care Hospitals · Vancouver, WA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number500150

Location2211 NE 139th StreetVancouver, WA 98686 · Clark County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49503 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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

87.54

Promoting Interoperability

100

Improvement Activities

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.

DR. NICHOLAS ALEXANDER STEPHANOFF M.D.

Family Medicine

426 MICHIGAN ST NE
GRAND RAPIDS, MI 49503

Kent County (616) 267-7888

RITA DEKKER

Nurse Practitioner

426 MICHIGAN ST NE
GRAND RAPIDS, MI 49503

Kent County (616) 391-2778

JENNIFER MARIE SHANLEY CNM

Advanced Practice Midwife

426 MICHIGAN ST NE
GRAND RAPIDS, MI 49503

Kent County (616) 391-3302

MICHIGAN STREET OPTICAL

Durable Medical Equipment & Medical Supplies

426 MICHIGAN ST NE, SUITE 101
GRAND RAPIDS, MI 49503

Kent County (616) 459-1844

AMY COX MD

Family Medicine

426 MICHIGAN ST NE
GRAND RAPIDS, MI 49503

Kent County (616) 267-7888

TAMI JOY MICHELE DO

Obstetrics & Gynecology

426 MICHIGAN ST NE
GRAND RAPIDS, MI 49503

Kent County (616) 391-3302

MARGUERITE B SOWERS PA-C

Physician Assistant (Medical)

426 MICHIGAN ST NE, SUITE 201
GRAND RAPIDS, MI 49503

Kent County (616) 459-8209

LYNN EBERTS FAGERMAN PNP

Nurse Practitioner (Pediatrics)

426 MICHIGAN ST NE, SUITE 102
GRAND RAPIDS, MI 49503

Kent County (616) 391-2957

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 Molly Tiesenga's NPI number?

The NPI number for Molly Tiesenga is 1063977932. It was assigned to this individual provider in the NPPES registry on February 5, 2019.

Where is Molly Tiesenga located?

Molly Tiesenga practices at 426 Michigan St NE, Grand Rapids, MI 49503. The listed phone number is (616) 267-8338.

What is Molly Tiesenga's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Is Molly Tiesenga enrolled in Medicare?

Yes. Molly Tiesenga 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 Molly Tiesenga accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc. and Regence BlueCross BlueShield of Oregon list Molly Tiesenga 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 Molly Tiesenga affiliated with any hospitals?

According to CMS data, Molly Tiesenga is affiliated with Legacy Good Samaritan Medical Center, Legacy Meridian Park Medical Center and Legacy Salmon Creek Medical Center.

When was this NPI record last updated?

The NPPES record for Molly Tiesenga was last updated on April 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.