LORI SUE NIEBOER P.A.-C
NPI 1174810667
Physician Assistant - Medical in Rockford, MI

Active since July 05, 2011PECOS EnrolledAccepts Medicare Assignment
4685 BELDING RD NE, ROCKFORD, MI 49341(616) 252-3100 Get Directions Write a Review

NPPES record last updated: February 2, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Lori Sue Nieboer P.a.-c NPPES

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

LORI SUE NIEBOER P.A.-C (NPI 1174810667) is an individual medical provider in Rockford, Michigan, licensed in Michigan (5601006254) and active in the NPI registry since July 2011. She is enrolled in Medicare PECOS, is affiliated with University Of Michigan Health - West, and is a graduate of Other (2010).

NPPES Registry Identity

NPI1174810667
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameLORI SUE NIEBOERCredential: P.A.-C
Location Address4685 BELDING RD NERockford, MI 49341-9605
Mailing Address4685 Belding Rd NeRockford, MI 49341-9605 · (616) 252-3100
Sole ProprietorYes
Medical School CMSOtherGraduated 2010
Enumeration DateJuly 5, 2011
Last NPPES UpdateFebruary 2, 2023
NPPES CertifiedFebruary 2, 2023
NPI 1174810667 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
Licenses Licensed in MI · 5601006254 Licensed in GA · 006100
4685 BELDING RD NE, Rockford, MI 49341

Accepted 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

Lori Sue Nieboer P.a.-c 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 ID3476714270
PECOS Enrollment IDI20120420000450
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.
50 services38 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.
34 services28 patients

Hospital Affiliations CMS Care Compare

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

University Of Michigan Health - West

Acute Care Hospitals · Wyoming, MI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230236
Location5900 Byron Center Avenue, SWWyoming, MI 49519 · Kent County
Emergency services Birthing friendly

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Family Medicine
4685 BELDING RD NE
ROCKFORD, MI 49341
Family Medicine
4685 BELDING RD NE
ROCKFORD, MI 49341
Family Medicine
4685 BELDING RD NE
ROCKFORD, MI 49341
Physician Assistant
4685 BELDING RD NE
ROCKFORD, MI 49341
Pediatrics
4685 BELDING RD NE
ROCKFORD, MI 49341
Physician Assistant
4685 BELDING RD NE
ROCKFORD, MI 49341
Pediatrics
4685 BELDING RD NE
ROCKFORD, MI 49341

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 Lori Nieboer's NPI number?

The NPI number for Lori Nieboer is 1174810667. It was assigned to this individual provider in the NPPES registry on July 5, 2011.

Where is Lori Nieboer located?

Lori Nieboer practices at 4685 Belding Rd NE, Rockford, MI 49341. The listed phone number is (616) 252-3100.

What is Lori Nieboer's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Lori Nieboer enrolled in Medicare?

Yes. Lori Nieboer 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 Lori Nieboer accept?

Health plans from Priority Health list Lori Nieboer 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 Lori Nieboer affiliated with any hospitals?

According to CMS data, Lori Nieboer is affiliated with University Of Michigan Health - West.

When was this NPI record last updated?

The NPPES record for Lori Nieboer was last updated on February 2, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.