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PLASTIC SURGERY ASSOCIATES PC
NPI 1093899767
Plastic Surgery in Grand Rapids, MI

Active since October 25, 2006CLIA 23D0926444 · Waiver
220 LYON ST NW, SUITE 700, GRAND RAPIDS, MI 49503(616) 451-4500(616) 451-9077 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Plastic Surgery Associates Pc NPPES

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

PLASTIC SURGERY ASSOCIATES PC (NPI 1093899767) is a healthcare organization registered as a plastic surgery in Grand Rapids, Michigan and active in the NPI registry since October 2006. The organization holds a CLIA Waiver certificate valid through March 23, 2027 and lists Deborah Houghton-redding, Manager, as its authorized official.

NPPES Registry Identity

NPI1093899767
Entity TypeOrganization
Primary Taxonomy208200000X
Legal Business NamePLASTIC SURGERY ASSOCIATES PC
Location Address220 LYON ST NW, SUITE 700Grand Rapids, MI 49503-2208
Mailing Address220 Lyon St Nw, Suite 700Grand Rapids, MI 49503-2208 · (616) 451-4500 · Fax (616) 451-9077
Phone(616) 451-4500
Fax(616) 451-9077
Organization SubpartNo
Authorized OfficialDeborah Houghton-reddingManager · (616) 451-4500
Enumeration DateOctober 25, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1093899767 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPlastic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208200000X
Definition
A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.
220 LYON ST NW, Grand Rapids, MI 49503
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Plastic Surgery Associates Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Plastic Surgery Associates PC, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 4 within 10 miles. They are listed nearest first.

Clinicians, nearest first (4)

Marguerite Aitken, M.D.
Plastic and Reconstructive Surgery
NPI 1982609095
220 LYON ST NW STE 700
Grand Rapids, MI 49503
(616) 451-4500
✔ PECOS✔ Accepts MedicareSame address
John Renucci, M.D.
Plastic and Reconstructive Surgery
NPI 1487659827
220 LYON ST NW STE 700
Grand Rapids, MI 49503
(616) 451-4500
✔ PECOSSame address
Douglas Vander Woude, MD
Plastic and Reconstructive Surgery
NPI 1235133653
220 LYON ST NW STE 700
Grand Rapids, MI 49503
(616) 451-4500
✔ PECOS✔ Accepts MedicareSame address
Johanna Krebiehl, M.D.
Plastic and Reconstructive Surgery
NPI 1487967733
221 MICHIGAN ST NE
Grand Rapids, MI 49503
(248) 703-5269
✔ PECOS✔ Accepts Medicare0.6 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D0926444

Plastic Surgery Associates, PC · Grand Rapids, MI
Active · expires Mar 23, 2027
CLIA Number23D0926444
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateMarch 24, 2025
Certificate Expiration DateMarch 23, 2027
Laboratory DirectorDouglas A. Vander Woude
Laboratory Phone(616) 451-4500
Laboratory LocationPlastic Surgery Associates, PC220 Lyon Street NW Suite 600, Grand Rapids, MI 49503
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Plastic Surgery Associates PC's NPI number?

The NPI number for Plastic Surgery Associates PC is 1093899767. It was assigned to this organization in the NPPES registry on October 25, 2006.

Where is Plastic Surgery Associates PC located?

Plastic Surgery Associates PC is located at 220 Lyon St NW Suite 700, Grand Rapids, MI 49503. The listed phone number is (616) 451-4500.

What is Plastic Surgery Associates PC's specialty?

The primary specialty registered for this NPI is Plastic Surgery with taxonomy code 208200000X.

Is Plastic Surgery Associates PC enrolled in Medicare?

Yes. Plastic Surgery Associates PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Plastic Surgery Associates PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians, all in Plastic and Reconstructive Surgery, reassign their Medicare billing to Plastic Surgery Associates PC. A 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 the clinician's services. Of these, 3 practice at this address and 4 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Plastic Surgery Associates PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D0926444) is associated with this NPI, valid through March 23, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Plastic Surgery Associates PC accept?

Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Plastic Surgery Associates PC 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 Plastic Surgery Associates PC was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.