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SIXTY FOURTH STREET LLC
NPI 1164538286
Clinic/Center - Ambulatory Surgical in Byron Center, MI

Active since August 22, 2006CLIA 23D1058632 · Waiver
2373 64TH ST SW, SUITE 2200, BYRON CENTER, MI 49315(616) 685-3975(616) 685-3977 Get Directions Write a Review

NPPES record last updated: April 23, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Sixty Fourth Street Llc NPPES

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

SIXTY FOURTH STREET LLC (NPI 1164538286) is a healthcare organization registered as an ambulatory surgical in Byron Center, Michigan and active in the NPI registry since August 2006. The organization holds a CLIA Waiver certificate valid through September 10, 2026 and lists Andrew Livingston, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1164538286
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameSIXTY FOURTH STREET LLC
Location Address2373 64TH ST SW, SUITE 2200Byron Center, MI 49315-7974
Mailing Address2373 64th St Sw, Suite 2200Byron Center, MI 49315-7974 · (616) 685-3975 · Fax (616) 685-3977
Phone(616) 685-3975
Fax(616) 685-3977
Organization SubpartNo
Authorized OfficialAndrew LivingstonMedical Director · (616) 685-3975
Enumeration DateAugust 22, 2006
Last NPPES UpdateApril 23, 2018
✔ NPI 1164538286 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
2373 64TH ST SW, Byron Center, MI 49315
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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, Oscar Insurance Company and more.Insurance ›

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 23D1058632

Sixty Fourth Street LLC · Byron Center, MI
Active · expires Sep 10, 2026
CLIA Number23D1058632
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateSeptember 11, 2024
Certificate Expiration DateSeptember 10, 2026
Laboratory DirectorTimothy Henne
Laboratory Phone(616) 685-3975
Laboratory LocationSixty Fourth Street LLC2373 64th Street Suite 2200, Byron Center, MI 49315
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 5

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.

Release of wrist ligament using an endoscope 29848
This procedure involves using a small camera, called an endoscope, to view and treat a tight wrist ligament. The endoscope is inserted through a tiny incision, reducing recovery time and scarring. It helps to relieve pain and improve wrist function.
41 services34 patients
Incision of tendon covering of finger 26055
This procedure involves making a small cut into the protective sheath around a finger tendon. It's typically done to relieve pressure or inflammation, improve finger movement, or treat conditions like trigger finger. It's a safe, often outpatient procedure.
15 services12 patients
Full thickness skin graft to nose, ears, eyelids, or lips, 20.0 sq cm or less 15260
A full thickness skin graft is a procedure where a layer of skin is taken from one area of the body and transplanted to another. If it's done on the nose, ears, eyelids, or lips, it helps restore these areas when damaged. The size of the graft is 20.0 sq cm or less.
12 services12 patients
Replacement of knee joint, both sides of knee 27447
A bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.
12 services12 patients
Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm 14061
This procedure involves repairing a wound on the eyelids, nose, ears, or lips by transferring skin from another part of the body. The size of the skin transferred will be between 10.1 to 30.0 square centimeters. It is performed to restore function and appearance.
11 services11 patients

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.

THOMAS B FOSTER MD
Internal Medicine (Adolescent Medicine)
2373 64TH ST SW, STE 1300
GRAND RAPIDS, MI 49315
Kent County (616) 685-1350
SARA VANDERZWAAG NP
Nurse Practitioner (Family)
2373 64TH ST SW, STE 1300
BYRON CENTER, MI 49315
Kent County (616) 685-1350
MR. BRIAN JAMES MULDER RPH
Pharmacist
2373 64TH ST SW, SUITE 1100
BYRON CENTER, MI 49315
Kent County (616) 643-3950
KIMBERLY LANNING
Nurse Practitioner (Family)
2373 64TH ST SW, STE 1300
BYRON CENTER, MI 49315
Kent County (616) 685-1350
FAMILY PHARMACY-SW CAMPUS
Pharmacy (Community/Retail Pharmacy)
2373 64TH ST SW, STE 1100
BYRON CENTER, MI 49315
Kent County (616) 685-3950
THERESA K STARR CNM
Advanced Practice Midwife
2373 64TH ST SW, STE 1300
BYRON CENTER, MI 49315
Kent County (616) 685-1350
EMILY ANNE RUSTICUS NP
Nurse Practitioner (Family)
2373 64TH ST SW, SUITE 1300
BYRON CENTER, MI 49315
Kent County (616) 685-1350
MRS. AMANDA MARIE EARDLEY RPH
Pharmacist
2373 64TH ST SW, SUITE 1100
BYRON CENTER, MI 49315
Kent County (616) 643-3950

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 Sixty Fourth Street LLC's NPI number?

The NPI number for Sixty Fourth Street LLC is 1164538286. It was assigned to this organization in the NPPES registry on August 22, 2006.

Where is Sixty Fourth Street LLC located?

Sixty Fourth Street LLC is located at 2373 64th St SW Suite 2200, Byron Center, MI 49315. The listed phone number is (616) 685-3975.

What is Sixty Fourth Street LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Does Sixty Fourth Street LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D1058632) is associated with this NPI, valid through September 10, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Sixty Fourth Street LLC accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Oscar Insurance Company and Priority Health list Sixty Fourth Street LLC 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 Sixty Fourth Street LLC was last updated on April 23, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.