ANDREA DURHAM FNP
NPI 1295403160
Nurse Practitioner - Family in East Lansing, MI

Q: What is Andrea Durham's NPI number?

The NPI number for Andrea Durham is 1295403160. It was assigned to this individual provider in the NPPES registry on September 3, 2021.

Q: What is Andrea Durham's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Andrea Durham was last updated on January 11, 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.

Active since September 03, 2021PECOS EnrolledAccepts Medicare Assignment

1675 WATERTOWER PL STE 600, EAST LANSING, MI 48823(517) 324-3445 Get Directions Write a Review

NPPES record last updated: January 11, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 11, 2023, Oct 18, 2022 (2 updates tracked since 2022).

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About Andrea Durham Fnp NPPES

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

ANDREA DURHAM FNP (NPI 1295403160) is an individual family provider in East Lansing, Michigan, licensed in Michigan (4704280715) and active in the NPI registry since September 2021. She is enrolled in Medicare PECOS, is affiliated with Henry Ford Allegiance Health, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1295403160

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameANDREA DURHAMCredential: FNP

Location Address1675 WATERTOWER PL STE 600East Lansing, MI 48823-8044

Mailing Address1 Ford Pl Ste 3aDetroit, MI 48202-3450 · (313) 874-4806

Phone(517) 324-3445

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateSeptember 3, 2021

Last NPPES UpdateJanuary 11, 20232 updates tracked since enumeration

NPPES CertifiedJanuary 11, 2023

✔ NPI 1295403160 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in MI · 4704280715

1675 WATERTOWER PL STE 600, East Lansing, MI 48823

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.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

Andrea Durham Fnp 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 ID9931582533

PECOS Enrollment IDI20220815001794

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 3

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.

173 services121 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.

82 services66 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

36 services36 patients

Hospital Affiliations CMS Care Compare

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

Henry Ford Allegiance Health

Acute Care Hospitals · Jackson, MI

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number230092

Location205 N East AveJackson, MI 49201 · Jackson County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48823 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.

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 Andrea Durham's NPI number?

The NPI number for Andrea Durham is 1295403160. It was assigned to this individual provider in the NPPES registry on September 3, 2021.

Where is Andrea Durham located?

Andrea Durham practices at 1675 Watertower Pl Ste 600, East Lansing, MI 48823. The listed phone number is (517) 324-3445.

What is Andrea Durham's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Andrea Durham enrolled in Medicare?

Yes. Andrea Durham 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 Andrea Durham accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 2 other insurers list Andrea Durham 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 Andrea Durham affiliated with any hospitals?

According to CMS data, Andrea Durham is affiliated with Henry Ford Allegiance Health.

When was this NPI record last updated?

The NPPES record for Andrea Durham was last updated on January 11, 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.