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MADISEN DUNCAN PMHNP-BC
NPI 1245919869
Nurse Practitioner - Psychiatric/Mental Health in Grand Rapids, MI

Active since July 12, 2023PECOS EnrolledAccepts Medicare Assignment
3950 SPARKS DR SE STE 103, GRAND RAPIDS, MI 49546(616) 726-1318 Get Directions Write a Review

NPPES record last updated: November 20, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Nov 20, 2024, Jul 12, 2023 (2 updates tracked since 2023).

About Madisen Duncan Pmhnp-bc NPPES

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

MADISEN DUNCAN PMHNP-BC (NPI 1245919869) is an individual psychiatric/mental health provider in Grand Rapids, Michigan, licensed in Michigan (4704419991) and active in the NPI registry since July 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1245919869
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameMADISEN DUNCANCredential: PMHNP-BC
Location Address3950 SPARKS DR SE STE 103Grand Rapids, MI 49546-6159
Mailing Address3950 Sparks Dr Se Ste 103Grand Rapids, MI 49546-6159 · (616) 726-1318
Phone(616) 726-1318
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateJuly 12, 2023
Last NPPES UpdateNovember 20, 20242 updates tracked since enumeration
NPPES CertifiedNovember 20, 2024
✔ NPI 1245919869 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
Licenses✔ Licensed in MI · 4704419991✔ Licensed in TN · 34275
3950 SPARKS DR SE STE 103, Grand Rapids, MI 49546
Open in Google Maps ↗

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, Priority Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Madisen Duncan Pmhnp-bc 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 ID8224473871
PECOS Enrollment IDI20250224002185
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Madisen Duncan reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Downriver Mental Health Clinic PC
93 mi
Psychologist
7600 GRAND RIVER RD, SUITE 290
Brighton, MI 48114
  • Reassigned Medicare billing, Michigan enrollment
  • 451 clinicians in this Medicare group
NPI 1225165715 (810) 220-2787
Southland Behavioral Health
489 mi
Psychiatric/Mental Health
9220 PARK WEST BLVD STE 1
Knoxville, TN 37923
  • Reassigned Medicare billing, Tennessee enrollment
  • 15 clinicians in this Medicare group
NPI 1336596584 (865) 247-6754

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49546 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.74 typical visit price
range $54.34 – $166.68
Typical copayment $21.18 (range $13.58 – $41.67)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.09 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 6

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

ELIZABETH KAHARI PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
3950 SPARKS DR SE STE 103
GRAND RAPIDS, MI 49546
Kent County (517) 882-3732
JAMIE LEE RINGELBERG LPC
Counselor (Professional)
3950 SPARKS DR SE STE 103
GRAND RAPIDS, MI 49546
Kent County (517) 492-0784
AGNES MUHIMPUNDU NP
Nurse Practitioner (Psychiatric/Mental Health)
3950 SPARKS DR SE STE 103
GRAND RAPIDS, MI 49546
Kent County (616) 726-1318
GLADYS O KUIK NP CERTIFICATION
Nurse Practitioner (Psychiatric/Mental Health)
3950 SPARKS DR SE STE 103
GRAND RAPIDS, MI 49546
Kent County (517) 882-3732
CHRISTINE LEADBETTER LPCC
Counselor (Mental Health)
3950 SPARKS DR SE STE 103
GRAND RAPIDS, MI 49546
Kent County (517) 492-0784
HEIDI LYNN DYGERT LMSW
Social Worker (Clinical)
3950 SPARKS DR SE STE 103
GRAND RAPIDS, MI 49546
Kent County (616) 455-5000

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 Madisen Duncan's NPI number?

The NPI number for Madisen Duncan is 1245919869. It was assigned to this individual provider in the NPPES registry on July 12, 2023.

Where is Madisen Duncan located?

Madisen Duncan practices at 3950 Sparks Dr SE Ste 103, Grand Rapids, MI 49546. The listed phone number is (616) 726-1318.

What is Madisen Duncan's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Madisen Duncan enrolled in Medicare?

Yes. Madisen Duncan 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.

Which organizations bill Medicare for Madisen Duncan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Madisen Duncan reassigns Medicare benefits to 2 organizations: Downriver Mental Health Clinic PC (Brighton, MI) and Southland Behavioral Health (Knoxville, TN). Each 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 Madisen Duncan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Madisen Duncan accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Priority Health and UnitedHealthcare list Madisen Duncan 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 Madisen Duncan was last updated on November 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months 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.