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J PATRICK DUIVEN PSYD PC
NPI 1124328265
Psychologist - Clinical in Grand Rapids, MI

Active since October 22, 2010
4133 EMBASSY DR SE, GRAND RAPIDS, MI 49546(616) 956-6700(616) 956-6773 Get Directions Write a Review

NPPES record last updated: October 22, 2010. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About J Patrick Duiven Psyd Pc NPPES

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

J PATRICK DUIVEN PSYD PC (NPI 1124328265) is a healthcare organization registered as a clinical in Grand Rapids, Michigan and active in the NPI registry since October 2010. The organization lists J Patrick Duiven, President/owner, as its authorized official.

NPPES Registry Identity

NPI1124328265
Entity TypeOrganization
Primary Taxonomy103TC0700X
Legal Business NameJ PATRICK DUIVEN PSYD PC
Location Address4133 EMBASSY DR SEGrand Rapids, MI 49546-2418
Mailing Address4133 Embassy Dr SeGrand Rapids, MI 49546-2418 · (616) 956-6700 · Fax (616) 956-6773
Phone(616) 956-6700
Fax(616) 956-6773
Organization SubpartNo
Authorized OfficialJ Patrick DuivenPresident/owner · (616) 956-6700
Enumeration DateOctober 22, 2010
✔ NPI 1124328265 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in MI · 6301002423
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
4133 EMBASSY DR SE, Grand Rapids, MI 49546
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Other Identifiers 1

Medicare PINON11770MI

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

J Patrick Duiven Psyd Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to J Patrick Duiven Psyd PC, which bills Medicare for the services this clinician delivers.

Clinician (1)

John Duiven, PSY.D.
Clinical Psychologist
NPI 1972685527
4133 EMBASSY DR SE
Grand Rapids, MI 49546
(616) 956-6700
✔ PECOS✔ Accepts MedicareSame address

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

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 J Patrick Duiven Psyd PC's NPI number?

The NPI number for J Patrick Duiven Psyd PC is 1124328265. It was assigned to this organization in the NPPES registry on October 22, 2010.

Where is J Patrick Duiven Psyd PC located?

J Patrick Duiven Psyd PC is located at 4133 Embassy Dr SE, Grand Rapids, MI 49546. The listed phone number is (616) 956-6700.

What is J Patrick Duiven Psyd PC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is J Patrick Duiven Psyd PC enrolled in Medicare?

Yes. J Patrick Duiven Psyd PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through J Patrick Duiven Psyd PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to J Patrick Duiven Psyd 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for J Patrick Duiven Psyd PC was last updated on October 22, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.