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MRS. STACEY NICOLE BRUURSEMA LMSW
NPI 1679086532
Social Worker - Clinical in Ann Arbor, MI

Active since November 14, 2017PECOS Enrolled
4350 JACKSON RD STE 300, ANN ARBOR, MI 48103(800) 877-3166 Get Directions Write a Review

NPPES record last updated: July 29, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jul 29, 2026, Jul 15, 2026, Nov 14, 2017 (3 updates tracked since 2017).

About Mrs. Stacey Nicole Bruursema Lmsw NPPES

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

MRS. STACEY NICOLE BRUURSEMA LMSW (NPI 1679086532) is an individual clinical provider in Ann Arbor, Michigan, licensed in Michigan (6801103855) and active in the NPI registry since November 2017. She is enrolled in Medicare PECOS and is a graduate of Other (2016).

NPPES Registry Identity

NPI1679086532
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMRS. STACEY NICOLE BRUURSEMACredential: LMSW
Location Address4350 JACKSON RD STE 300Ann Arbor, MI 48103-1889
Mailing Address24 Frank Lloyd Wright Dr Ste J2000Ann Arbor, MI 48105-9484 · (734) 747-6766
Phone(800) 877-3166
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateNovember 14, 2017
Last NPPES UpdateJuly 29, 20263 updates tracked since enumeration
NPPES CertifiedJuly 29, 2026
✔ NPI 1679086532 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in MI · 6801103855
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
4350 JACKSON RD STE 300, Ann Arbor, MI 48103
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Stacey Nicole Bruursema Lmsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID941766968
PECOS Enrollment IDI20260730001162
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.

Medicare Billing Reassignment

Medicare enrollment records show Stacey Bruursema reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Iha Health Services Corporation
Same address
Family Medicine
4350 JACKSON RD, SUITE 200
Ann Arbor, MI 48103
  • Reassigned Medicare billing, Michigan enrollment
  • 1,480 clinicians in this Medicare group
NPI 1366599409 (734) 761-2581

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48103 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
$0.00 typical visit price
range $58.04 – $177.36
Typical copayment $0.00 (range $14.51 – $44.34)
Most-billed visit code NA
Established Patient
$72.38 typical visit price
range $18.32 – $143.49
Typical copayment $18.09 (range $4.58 – $35.87)
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 9

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

JOANNE VICARI BLOCK M.D.
Obstetrics & Gynecology
4350 JACKSON RD STE 300
ANN ARBOR, MI 48103
Washtenaw County (734) 995-2259
ADAM M ZIFF DO
Obstetrics & Gynecology
4350 JACKSON RD STE 300
ANN ARBOR, MI 48103
Washtenaw County (734) 995-2259
MS. JESSICA MARIE MEZA LMSW
Social Worker (Clinical)
4350 JACKSON RD STE 300
ANN ARBOR, MI 48103
Washtenaw County (800) 777-3166
DR. KIM PALFEY M.D.
Obstetrics & Gynecology
4350 JACKSON RD STE 300
ANN ARBOR, MI 48103
Washtenaw County (734) 995-2259
DR. CHRISTINA NICOLE DARIN MD
Obstetrics & Gynecology
4350 JACKSON RD STE 300
ANN ARBOR, MI 48103
Washtenaw County (734) 995-2259
MRS. DANIELA L HAGEN
Clinical Nurse Specialist (Psychiatric/Mental Health, Adult)
4350 JACKSON RD STE 300
ANN ARBOR, MI 48103
Washtenaw County (800) 777-3166
MEGAN ELIZABETH ZEIHER FNP-BC
Nurse Practitioner (Family)
4350 JACKSON RD STE 300
ANN ARBOR, MI 48103
Washtenaw County (734) 995-2259
DR. CATRIONA ANNE MACARDLE MD
Obstetrics & Gynecology
4350 JACKSON RD STE 300
ANN ARBOR, MI 48103
Washtenaw County (734) 995-2259

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 Stacey Bruursema's NPI number?

The NPI number for Stacey Bruursema is 1679086532. It was assigned to this individual provider in the NPPES registry on November 14, 2017.

Where is Stacey Bruursema located?

Stacey Bruursema practices at 4350 Jackson Rd Ste 300, Ann Arbor, MI 48103. The listed phone number is (800) 877-3166.

What is Stacey Bruursema's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Stacey Bruursema enrolled in Medicare?

Yes. Stacey Bruursema is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Stacey Bruursema's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Stacey Bruursema reassigns Medicare benefits to Iha Health Services Corporation (Ann Arbor, MI). 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 Stacey Bruursema's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Stacey Bruursema accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 1 other insurer list Stacey Bruursema 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 Stacey Bruursema was last updated on July 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.