MARISSA BULTSMA
NPI 1407708969
Social Worker - Clinical in Kentwood, MI
About Marissa Bultsma NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARISSA BULTSMA (NPI 1407708969) is an individual clinical provider in Kentwood, Michigan, licensed in Michigan (6801115146) and active in the NPI registry since February 2026. She is enrolled in Medicare PECOS and is a graduate of Other (2020).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Marissa Bultsma is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Marissa Bultsma reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Grand Rapids, MI 49506
- Reassigned Medicare billing, Michigan enrollment
- 287 clinicians in this Medicare group
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 49508 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 12
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
KENTWOOD, MI 49508
KENTWOOD, MI 49508
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 Marissa Bultsma's NPI number?
The NPI number for Marissa Bultsma is 1407708969. It was assigned to this individual provider in the NPPES registry on February 9, 2026.
Where is Marissa Bultsma located?
Marissa Bultsma practices at 1403 60th St SE, Kentwood, MI 49508. The listed phone number is (616) 485-9561.
What is Marissa Bultsma's specialty?
The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.
Is Marissa Bultsma enrolled in Medicare?
Yes. Marissa Bultsma is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Marissa Bultsma's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Marissa Bultsma reassigns Medicare benefits to Counseling Center Of West Michigan, LLC (Grand Rapids, MI). The 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 Marissa Bultsma's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Marissa Bultsma 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 3 other insurers list Marissa Bultsma 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 Marissa Bultsma was last updated on February 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.
# Marissa Bultsma · NPI 1407708969
Clinical provider in Kentwood, Michigan. Individual provider, active in the CMS NPPES registry since February 9, 2026.
## Identity
- **NPI:** 1407708969 (Entity type: Individual)
- **Enumerated:** February 9, 2026
- **Primary specialty:** Social Worker - Clinical · taxonomy 1041C0700X
- **State license:** 6801115146 (Michigan)
- **Sole proprietor:** No
## Practice location
- **Address:** 1403 60TH ST SE, Kentwood, MI 49508-7065
- **Phone:** (616) 485-9561
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Counseling Center Of West Michigan, LLC (NPI 1437610730, Grand Rapids, MI), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2020
## Record status
- **NPPES last updated:** February 9, 2026
---
Source: [NPI Profile](https://npiprofile.com/npi/1407708969) · Data from the CMS NPPES public registry.