KIVA DA-SHAN BAUSWELL A-GNP
NPI 1508531088
Nurse Practitioner - Gerontology in Grand Rapids, MI

Active since August 16, 2021PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
145 MICHIGAN ST NE STE 3410, GRAND RAPIDS, MI 49503(616) 391-9945 Get Directions Write a Review

NPPES record last updated: May 4, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: May 4, 2023, Aug 16, 2021 (2 updates tracked since 2021).

About Kiva Da-shan Bauswell A-gnp NPPES

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

KIVA DA-SHAN BAUSWELL A-GNP (NPI 1508531088) is an individual gerontology provider in Grand Rapids, Michigan, licensed in Michigan (4704291746) and active in the NPI registry since August 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1508531088
Entity TypeIndividualFemale
Primary Taxonomy363LG0600X
Provider Legal NameKIVA DA-SHAN BAUSWELLCredential: A-GNP
Location Address145 MICHIGAN ST NE STE 3410Grand Rapids, MI 49503-2563
Mailing Address100 Michigan St Ne # Mc845Grand Rapids, MI 49503-2560 · (616) 486-6790
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateAugust 16, 2021
Last NPPES UpdateMay 4, 20232 updates tracked since enumeration
NPPES CertifiedMay 4, 2023
NPI 1508531088 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LG0600X
License Licensed in MI · 4704291746
145 MICHIGAN ST NE STE 3410, Grand Rapids, MI 49503

Other Names 1

Former Name (1)Kiva Da-shan Bauswell-harris A-gnp

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

Kiva Da-shan Bauswell A-gnp 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 ID143626895
PECOS Enrollment IDI20210907000651
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.

Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes 99349
An established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.
62 services21 patients
Advance care planning, first 30 minutes 99497
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
46 services26 patients
Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes 99350
An established patient home visit is a service where a healthcare professional visits a patient's home for a check-up or treatment. The visit typically lasts for about an hour. This service is especially beneficial for patients who may have difficulty traveling to a healthcare facility.
22 services15 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49503 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
$96.44 typical visit price
range $17.09 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
Most-billed visit code 99214
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
Quality87.54
Promoting Interoperability100
Improvement Activities40

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.

Physician Assistant (Medical)
145 MICHIGAN ST NE STE 3410
GRAND RAPIDS, MI 49503
Internal Medicine (Hospice and Palliative Medicine)
145 MICHIGAN ST NE STE 3410
GRAND RAPIDS, MI 49503
Nurse Practitioner
145 MICHIGAN ST NE STE 3410
GRAND RAPIDS, MI 49503
Nurse Practitioner (Gerontology)
145 MICHIGAN ST NE STE 3410
GRAND RAPIDS, MI 49503
Nurse Practitioner (Acute Care)
145 MICHIGAN ST NE STE 3410
GRAND RAPIDS, MI 49503
Nurse Practitioner (Family)
145 MICHIGAN ST NE STE 3410
GRAND RAPIDS, MI 49503
Nurse Practitioner (Family)
145 MICHIGAN ST NE STE 3410
GRAND RAPIDS, MI 49503
Internal Medicine (Hospice and Palliative Medicine)
145 MICHIGAN ST NE STE 3410
GRAND RAPIDS, MI 49503

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1508531088, enumerated as an "individual" on August 16, 2021.

The provider is located at 145 MICHIGAN ST NE STE 3410 GRAND RAPIDS, MI 49503 and the phone number is (616) 391-9945.

Nurse Practitioner with taxonomy code 363LG0600X and a focus in Gerontology.

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.