ANDREW HALLETT MD
NPI 1477006591
Surgery in Grand Rapids, MI
About Andrew Hallett Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ANDREW HALLETT MD (NPI 1477006591) is an individual surgery provider in Grand Rapids, Michigan, licensed in Idaho (9271076) and active in the NPI registry since July 2016. He is enrolled in Medicare PECOS, is affiliated with St Lukes Magic Valley Medical Center, and is a graduate of Other (2017).
NPPES Registry Identity
Specialties & Licenses 2
Group Practice 1
Accepted 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
Andrew Hallett Md 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.
Medicare Billing Reassignment
Medicare enrollment records show Andrew Hallett reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Mountain Home, ID 83647
- Reassigned Medicare billing, Idaho enrollment
- 1,312 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.
Hospital Affiliations CMS Care Compare 3
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
St Lukes Magic Valley Medical Center
Acute Care Hospitals · Twin Falls, IDSt Luke's Regional Medical Center
Acute Care Hospitals · Boise, IDSt Luke's Nampa Medical Center
Acute Care Hospitals · Nampa, IDPhysician 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.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
GRAND RAPIDS, MI 49546
GRAND RAPIDS, MI 49546
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 Andrew Hallett's NPI number?
The NPI number for Andrew Hallett is 1477006591. It was assigned to this individual provider in the NPPES registry on July 25, 2016.
Where is Andrew Hallett located?
Andrew Hallett practices at 4100 Lake Dr SE Ste 205, Grand Rapids, MI 49546. The listed phone number is (616) 267-7100.
What is Andrew Hallett's specialty?
The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.
Is Andrew Hallett enrolled in Medicare?
Yes. Andrew Hallett 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 organization bills Medicare for Andrew Hallett's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Andrew Hallett reassigns Medicare benefits to St Lukes Clinic-Treasure Valley LLC (Mountain Home, ID). 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 Andrew Hallett's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Andrew Hallett accept?
Health plans from Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan and Select Health list Andrew Hallett 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 Andrew Hallett affiliated with any hospitals?
According to CMS data, Andrew Hallett is affiliated with St Lukes Magic Valley Medical Center, St Luke's Regional Medical Center and St Luke's Nampa Medical Center.
When was this NPI record last updated?
The NPPES record for Andrew Hallett was last updated on October 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.
# Andrew Hallett, MD · NPI 1477006591
Surgery physician in Grand Rapids, Michigan. Individual provider, active in the CMS NPPES registry since July 25, 2016.
## Identity
- **NPI:** 1477006591 (Entity type: Individual)
- **Enumerated:** July 25, 2016
- **Primary specialty:** Surgery · taxonomy 208600000X
- **State license:** 9271076 (Idaho)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 4100 LAKE DR SE STE 205, Grand Rapids, MI 49546-8292
- **Phone:** (616) 267-7100
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** St Lukes Clinic-Treasure Valley LLC (NPI 1417297821, Mountain Home, ID), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2017
## Record status
- **NPPES last updated:** October 28, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1477006591) · Data from the CMS NPPES public registry.