JERRY B VANLEEUWEN PHD PC
NPI 1497943146
Psychologist - Cognitive & Behavioral in Grand Rapids, MI
About Jerry B Vanleeuwen Phd Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JERRY B VANLEEUWEN PHD PC (NPI 1497943146) is a healthcare organization registered as a cognitive & behavioral in Grand Rapids, Michigan and active in the NPI registry since October 2007. The organization lists Jerry B. Van Leeuwen, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jerry B Vanleeuwen Phd Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by February 28, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Jerry B Vanleeuwen Phd PC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Jerry B Vanleeuwen Phd PC's NPI number?
The NPI number for Jerry B Vanleeuwen Phd PC is 1497943146. It was assigned to this organization in the NPPES registry on October 9, 2007.
Where is Jerry B Vanleeuwen Phd PC located?
Jerry B Vanleeuwen Phd PC is located at 6255 28th St SE Ste M, Grand Rapids, MI 49546. The listed phone number is (616) 458-5294.
What is Jerry B Vanleeuwen Phd PC's specialty?
The primary specialty registered for this NPI is Psychologist, specializing in Cognitive & Behavioral, with taxonomy code 103TB0200X.
Is Jerry B Vanleeuwen Phd PC enrolled in Medicare?
Yes. Jerry B Vanleeuwen Phd PC is registered in the Medicare PECOS enrollment system.
When is Jerry B Vanleeuwen Phd PC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Michigan, Clinic/Group Practice) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Jerry B Vanleeuwen Phd PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Marriage and Family Therapist) reassigns their Medicare billing to Jerry B Vanleeuwen Phd PC. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Jerry B Vanleeuwen Phd PC accept?
Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Jerry B Vanleeuwen Phd PC 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 Jerry B Vanleeuwen Phd PC was last updated on December 4, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Jerry B Vanleeuwen Phd Pc · NPI 1497943146
Cognitive & Behavioral organization in Grand Rapids, Michigan. Organization record, active in the CMS NPPES registry since October 9, 2007.
## Identity
- **NPI:** 1497943146 (Entity type: Organization)
- **Enumerated:** October 9, 2007
- **Primary specialty:** Psychologist - Cognitive & Behavioral · taxonomy 103TB0200X
- **Organization subpart:** No
- **Authorized official:** Jerry Van Leeuwen, PRESIDENT
## Practice location
- **Address:** 6255 28TH ST SE STE M, Grand Rapids, MI 49546-6966
- **Phone:** (616) 458-5294 · **Fax:** (616) 458-5295
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** February 28, 2027 (Non-DME Part B, Michigan, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Marriage and Family Therapist) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 4, 2023
- **Other identifiers:** Medicaid 1336340140 (MI)
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Source: [NPI Profile](https://npiprofile.com/npi/1497943146) · Data from the CMS NPPES public registry.