REGINA R KOORNDYK PA
NPI 1417050535
Physician Assistant in Grand Rapids, MI

Active since September 06, 2006PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
4100 LAKE DR SE STE 200, GRAND RAPIDS, MI 49546(616) 391-3759(616) 391-3052 Get Directions Write a Review

NPPES record last updated: February 25, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Feb 25, 2021, Jan 25, 2016 (2 updates tracked since 2016).

About Regina R Koorndyk Pa NPPES

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

REGINA R KOORNDYK PA (NPI 1417050535) is an individual physician assistant in Grand Rapids, Michigan, licensed in Michigan (5601004505) and active in the NPI registry since September 2006. She is enrolled in Medicare PECOS, is affiliated with Spectrum Health, and is a graduate of Other (2005).

NPPES Registry Identity

NPI1417050535
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameREGINA R KOORNDYKCredential: PA
Location Address4100 LAKE DR SE STE 200Grand Rapids, MI 49546-8292
Mailing Address100 Michigan St Ne, Mc845Grand Rapids, MI 49503-2560
Fax(616) 391-3052
Sole ProprietorNo
Medical School CMSOtherGraduated 2005
Enumeration DateSeptember 6, 2006
Last NPPES UpdateFebruary 25, 20212 updates tracked since enumeration
NPPES CertifiedFebruary 25, 2021
NPI 1417050535 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in MI · 5601004505
Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

4100 LAKE DR SE STE 200, Grand Rapids, MI 49546

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

Regina R Koorndyk Pa 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 ID4587699434
PECOS Enrollment IDI20050929000715
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 2024 & 2026 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 high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
88 services76 patients
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.
37 services36 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.
24 services24 patients

Hospital Affiliations CMS Care Compare

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

Spectrum Health

Acute Care Hospitals · Grand Rapids, MI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230038
Location100 Michigan St NEGrand Rapids, MI 49503 · Kent County
Emergency services Birthing friendly

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
$68.07 typical visit price
range $17.09 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality87.54
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 16

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
18 suppliers179 claims179 services$32.27 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
15 suppliers106 claims106 services$71.80 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
15 suppliers123 claims310 services$26.46 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
18 suppliers66 claims337 services$13.57 avg. paid by Medicare
Pillow for use on nasal cannula type interface, replacement only, pair A7033
DME-Other DME · category DE001N
12 suppliers62 claims333 services$13.05 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
21 suppliers146 claims146 services$46.86 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 19

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

Nurse Practitioner
4100 LAKE DR SE STE 200
GRAND RAPIDS, MI 49546
Internal Medicine (Pulmonary Disease)
4100 LAKE DR SE STE 200
GRAND RAPIDS, MI 49546
Internal Medicine (Pulmonary Disease)
4100 LAKE DR SE STE 200
GRAND RAPIDS, MI 49546
Psychiatry & Neurology (Sleep Medicine)
4100 LAKE DR SE STE 200
GRAND RAPIDS, MI 49546
Physician Assistant
4100 LAKE DR SE STE 200
GRAND RAPIDS, MI 49546
Internal Medicine (Sleep Medicine)
4100 LAKE DR SE STE 200
GRAND RAPIDS, MI 49546
Physician Assistant
4100 LAKE DR SE STE 200
GRAND RAPIDS, MI 49546
Internal Medicine (Sleep Medicine)
4100 LAKE DR SE STE 200
GRAND RAPIDS, MI 49546

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1417050535, enumerated as an "individual" on September 06, 2006.

The provider is located at 4100 LAKE DR SE STE 200 GRAND RAPIDS, MI 49546 and the phone number is (616) 391-3759.

Physician Assistant with taxonomy code 363A00000X.

The provider might be accepting Accepts: Blue Care Network of Michigan, Blue Cross Blue. Please consult your insurance carrier or call the provider to verify.

Regina Koorndyk is affiliated with: SPECTRUM HEALTH.