ANDREW HALLETT MD
NPI 1477006591
Surgery in Grand Rapids, MI

Q: 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.

Q: What is Andrew Hallett's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Q: 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 9 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.

Active since July 25, 2016PECOS EnrolledAccepts Medicare Assignment

4100 LAKE DR SE STE 205, GRAND RAPIDS, MI 49546(616) 267-7100 Get Directions Write a Review

NPPES record last updated: October 28, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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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 Luke's Regional Medical Center, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1477006591

Entity TypeIndividualMale

Primary Taxonomy208600000X

Provider Legal NameANDREW HALLETTCredential: MD

Location Address4100 LAKE DR SE STE 205Grand Rapids, MI 49546-8292

Mailing Address190 E Bannock StBoise, ID 83712-6241

Phone(616) 267-7100

Sole ProprietorYes

Medical School CMSOtherGraduated 2017

Enumeration DateJuly 25, 2016

Last NPPES UpdateOctober 28, 2025

NPPES CertifiedOctober 28, 2025

✔ NPI 1477006591 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208600000X

Licenses✔ Licensed in ID · 9271076✔ Licensed in MI · 4301512108✔ Licensed in PA · MT213958

Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

4100 LAKE DR SE STE 205, Grand Rapids, MI 49546

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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

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.

PECOS PAC ID4880971274

PECOS Enrollment IDI20251112001064

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.

Hospital Affiliations CMS Care Compare

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

St Luke's Regional Medical Center

Acute Care Hospitals · Boise, ID

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number130006

Location190 East Bannock StreetBoise, ID 83712 · Ada 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.

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.

ROSS REYNOLDS PA

Physician Assistant