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DR. JACK RICHARD ROOSSIEN JR. M.D.
NPI 1184610669
Family Medicine in West Olive, MI

Active since September 21, 2005
15151 STANTON ST, SUITE A, WEST OLIVE, MI 49460(616) 296-1020(616) 296-1030 Get Directions Write a Review

NPPES record last updated: June 7, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Jack Richard Roossien Jr. M.d. NPPES

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

DR. JACK RICHARD ROOSSIEN JR. M.D. (NPI 1184610669) is an individual family medicine provider in West Olive, Michigan, licensed in Michigan (JR050437) and active in the NPI registry since September 2005.

NPPES Registry Identity

NPI1184610669
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. JACK RICHARD ROOSSIEN JR.Credential: M.D.
Location Address15151 STANTON ST, SUITE AWest Olive, MI 49460-8543
Mailing AddressPo Box 1848Muskegon, MI 49443-1848 · (866) 611-1612 · Fax (231) 728-4789
Phone(616) 296-1020
Fax(616) 296-1030
Sole ProprietorNo
Enumeration DateSeptember 21, 2005
Last NPPES UpdateJune 7, 2019
✔ NPI 1184610669 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MI · JR050437
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
15151 STANTON ST, West Olive, MI 49460
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Other Identifiers 3

Medicaid1184610669MI
Medicaid4214810MI
OtherON13120MI · Medicare Group Number

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.

Reported Quality Measures

e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
99%2,000 patients4/55-star benchmark: 100%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
100%128 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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.

SEAN M CUNNINGHAM DO
Family Medicine
15151 STANTON ST
WEST OLIVE, MI 49460
Ottawa County (616) 685-1950
PHYSIOTHERAPY ASSOCIATES INC
Clinic/Center (Physical Therapy)
15151 STANTON ST, STE B
WEST OLIVE, MI 49460
Ottawa County (616) 844-1290
MERCY HEALTH PARTNERS
Clinic/Center (Rural Health)
15151 STANTON ST
WEST OLIVE, MI 49460
Ottawa County (616) 685-1950
LINDSEY ANN ROOSSIEN PA-C
Family Medicine (Adult Medicine)
15151 STANTON ST
WEST OLIVE, MI 49460
Ottawa County (616) 296-1020
STANTON CROSSINGS PHYSICAL THERAPY LLC
Physical Therapist
15151 STANTON ST, SUITE B
WEST OLIVE, MI 49460
Ottawa County (616) 296-9235
JACK R. ROOSSIEN JR., M.D.P.C.
Family Medicine
15151 STANTON ST, SUITE A
WEST OLIVE, MI 49460
Ottawa County (616) 296-1020
MRS. CARLY ANN GILBERT FNP-C
Nurse Practitioner (Family)
15151 STANTON ST
WEST OLIVE, MI 49460
Ottawa County (616) 685-1950

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 Jack Roossien's NPI number?

The NPI number for Jack Roossien is 1184610669. It was assigned to this individual provider in the NPPES registry on September 21, 2005.

Where is Jack Roossien located?

Jack Roossien practices at 15151 Stanton St Suite A, West Olive, MI 49460. The listed phone number is (616) 296-1020.

What is Jack Roossien's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Jack Roossien was last updated on June 7, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.