PROMEDICA HOSPICE (TRAVERSE CITY)
NPI 1699728980
Hospice Care, Community Based in Grand Rapids, MI
NPI Status: Active since May 18, 2006
Contact Information
695 KENMOOR AVE SE STE B
GRAND RAPIDS, MI
ZIP 49546
Phone: (616) 956-0636
Fax: (616) 956-7617
- Organization
- Hospice Care, Community Based
- Accepts Insurance
- CLIA Number: 23D0936161
- CLIA Cert. Type: Hospice
- CLIA Exp. Date: 09-15-2026
About PROMEDICA HOSPICE (TRAVERSE CITY)
This page provides the complete NPI Profile along with additional information for Promedica Hospice (traverse City), a provider established in Grand Rapids, Michigan operating as a Hospice Care, Community Based. The healthcare provider is registered in the NPI registry with number 1699728980 assigned on May 2006. The practitioner's primary taxonomy code is 251G00000X with license number 413526 (MI). The provider is registered as an organization and their NPI record was last updated 4 years ago. Promedica Hospice (traverse City) operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's is doing business as Promedica Hospice (traverse City). The authorized official of this NPI record is Mr. Martin D Allen (Director)
- NPI
- 1699728980
- Provider Legal Name
- HEARTLAND HOSPICE SERVICES LLC
- Other Organization Name
- PROMEDICA HOSPICE (TRAVERSE CITY)
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 695 KENMOOR AVE SE STE B GRAND RAPIDS, MI 49546
- Location Phone
- (616) 956-0636
- Location Fax
- (616) 956-7617
- Mailing Address
- 333 N SUMMIT ST ATTN: DEAN SHIPMAN TOLEDO, OH 43604
- Mailing Phone
- (419) 254-7841
- Mailing Fax
- (616) 956-7617
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-18-2006
- Last Update Date
- 04-15-2022
- Code Navigator
According to the Hospice Quality Reporting Program (HQRP) data this facility is for-profit and was certified on 01-13-1999 This facility was recently evaluated on the following quality measures: average daily census, hospice served at least 1 patient with both medicare and medicaid coverage during one year, hospice served at least 1 patient enrolled in medicare advantage during one year, care provided in assisted living facility and care provided in home, etc.
Location Map
Secondary Locations
- 4000 Eastern Sky Dr Ste 2
Traverse City, MI 49684
(231) 935-3089 - 8075 Creekside Dr Ste 120
Portage, MI 49024
(269) 324-5705 - 1053 W Main St
Fremont, MI 49412
(616) 956-0636
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Hospice Care, Community Based
- Taxonomy Code
- 251G00000X
- Type
- Agencies
- License No.
- 413526
- License State
- MI
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207RH0002X | Allopathic & Osteopathic Physicians | Internal Medicine |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Clear Gold - HMO
- Clear Gold + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Clear Silver - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Focused Silver + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Blue Cross� Local HMO Bronze Extra - HMO
- Blue Cross� Local HMO Bronze Secure - HMO
- Blue Cross� Local HMO Silver Extra - HMO
- Blue Cross� Local HMO Silver Saver - HMO
- Blue Cross� Preferred HMO Bronze Extra - HMO
- Blue Cross� Preferred HMO Bronze Saver HSA - HMO
- Blue Cross� Preferred HMO Bronze Secure - HMO
- Blue Cross� Preferred HMO Gold - HMO
- Blue Cross� Preferred HMO Gold Extra - HMO
- Blue Cross� Preferred HMO Silver - HMO
- Blue Cross� Premier PPO Bronze Extra - PPO
- Blue Cross� Premier PPO Bronze Saver HSA - PPO
- Blue Cross� Premier PPO Bronze Secure - PPO
- Blue Cross� Premier PPO Gold - PPO
- Blue Cross� Premier PPO Gold Extra - PPO
- Blue Cross� Premier PPO Silver - PPO
- Blue Cross� Premier PPO Silver Extra - PPO
- Blue Cross� Premier PPO Silver Saver HSA - PPO
- Blue Cross� Premier PPO Value - PPO
- MHP Bronze - HMO
- MHP Bronze Saver (Expanded) - HMO
- MHP Expanded Bronze Standard - HMO
- MHP Gold - HMO
- MHP Gold Standard - HMO
- MHP Silver Exchange - HMO
- MHP Silver Exchange Rewards - HMO
- MHP Silver Standard - HMO
- MHP Young Adult/Catastrophic - HMO
- MyPriority Balanced Silver - HMO
- MyPriority Balanced Silver Bronson Healthcare Partners - HMO
- MyPriority Balanced Silver Southeast Michigan Network - HMO
- MyPriority Balanced Silver Trinity Health East Network - HMO
- MyPriority Enhanced Gold Bronson Healthcare Partners - HMO
- MyPriority Enhanced Gold Southeast Michigan Network - HMO
- MyPriority Enhanced Gold Trinity Health East Network - HMO
- MyPriority Premier Silver - HMO
- MyPriority Premier Silver Bronson Healthcare Partners - HMO
- MyPriority Premier Silver Trinity Health East Network - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1413573 | MEDICAID (05) | MI |
Hospice Care Information
The Centers for Medicare and Medicaid Services Hospice Quality Reporting Program (HQRP) data provides information on the quality of care that hospice facilities are providing to their patients. The quality reporting data gives families and patients the information they need to decide which hospice is right for them.
| CMS Certification Number (CCN) | 231582 |
| Ownership Type | For-Profit |
| Medicare Certification Date | 01-13-1999 |
| Quality Measure | Measure Score |
|---|---|
| Average Daily Census Number of patients cared for by a hospice on average each day | 286.0 |
| Hospice served at least 1 patient with both Medicare and Medicaid coverage during one year 1= Hospice served at least 1 patient with both Medicaid and Medicare coverage OR 0 = Hospice did not serve any patients with both Medicaid and Medicare coverage | Yes |
| Hospice served at least 1 patient enrolled in Medicare Advantage during one year 1 = Hospice served at least one patient enrolled in Medicare Advantage OR 0 = Hospice did not serve any patients enrolled in Medicare Advantage | Yes |
| Care Provided in Assisted Living Facility Percentage of days patients received care in an assisted living facility | 23 |
| Care Provided in Home Percentage of days patients received care in home | 41 |
| Care Provided in Inpatient Hospice Facility Percentage of days patients received care in an inpatient hospice | 0 - Value is based on one year of data and does not indicate that the hospice would have 0% in more recent years. |
| Care Provided in Inpatient Hospital Facility Percentage of days patients received care in an inpatient hospital | 0 - Value is based on one year of data and does not indicate that the hospice would have 0% in more recent years. |
| Care Provided in Nursing Facility Percentage of days patients received care in a nursing facility | 34 |
| Care Provided in All other locations Percentage of days patients received care in other locations | 2 |
| Care Provided in Skilled Nursing Facility Percentage of days patients received care in a skilled nursing facility | 0 - Value is based on one year of data and does not indicate that the hospice would have 0% in more recent years. |
| Hospice and Palliative Care Treatment Preferences Facility observed rate | 100.0 |
| Beliefs & Values Addressed (if desired by the patient) Facility observed rate | 100.0 |
| Hospice and Palliative Care Pain Screening Facility observed rate | 99.9 |
| Hospice and Palliative Care Pain Assessment Facility observed rate | 100.0 |
| Hospice and Palliative Care Dyspnea Screening Facility observed rate | 99.9 |
| Hospice and Palliative Care Dyspnea Treatment Facility observed rate | 98.6 |
| Patient Treated with an Opioid Who Are Given a Bowel Regimen Facility observed rate | 100.0 |
| Hospice and Palliative Care Composite Process Measure Facility observed rate | 99.1 |
| Hospice Visits in the Last Days of Life | 1,217 |
| Hospice Visits in the Last Days of Life Facility observed rate | 66.1 |
| Hospice Care Index Overall Score Facility observed rate | 10.0 |
| CHC/GIP provided (% days) | 219,452 |
| CHC/GIP provided (% days) Facility observed rate | 0.0 |
| CHC/GIP provided (% days) | 51 |
| Gaps in nursing visits (% elections) | 1,119 |
| Gaps in nursing visits (% elections) Facility observed rate | 68.6 |
| Gaps in nursing visits (% elections) | 71 |
| Early live discharges (% live discharges) | 239 |
| Early live discharges (% live discharges) Facility observed rate | 4.2 |
| Early live discharges (% live discharges) | 36 |
| Late live discharges (% live discharges) | 239 |
| Late live discharges (% live discharges) Facility observed rate | 48.1 |
| Late live discharges (% live discharges) | 73 |
| Burdensome transitions, Type 1(% live discharges) | 239 |
| Burdensome transitions, Type 1 (% live discharges) Facility observed rate | 12.6 |
| Burdensome transitions, Type 1 (% live discharges) | 78 |
| Burdensome transitions, Type 2(% live discharges) | 239 |
| Burdensome transitions, Type 2 (% live discharges) Facility observed rate | 2.5 |
| Burdensome transitions, Type 2 (% live discharges) | 69 |
| Per-beneficiary spending (U.S. dollars $) | 1,815 |
| Per-beneficiary spending (U.S. dollars $) Facility observed rate | 19,175 |
| Per-beneficiary spending (U.S. dollars $) | 64 |
| Nurse care minutes per routine home care days (minutes) | 219,048 |
| Nurse care minutes per routine home care days (minutes) Facility observed rate | 9.6 |
| Nurse care minutes per routine home care days (minutes) | 21 |
| Skilled nursing minutes on weekends (% minutes) | 2,092,125 |
| Skilled nursing minutes on weekends (% minutes) Facility observed rate | 9.2 |
| Skilled nursing minutes on weekends (% minutes) | 63 |
| Visits near death (% decedents) | 1,380 |
| Visits near death (% decedents) Facility observed rate | 91.2 |
| Visits near death (% decedents) | 38 |
| Percent of Patients with Cancer Percentage of patients at hospice who had Cancer as their primary diagnosis | 18 |
| Percent of Patients with Circulatory/heart disease Percentage of patients at hospice who had Circulatory Heart Disease as their primary diagnosis | 22 |
| Percent of Patients with Dementia Percentage of patients at hospice who had Dementia as their primary diagnosis | 17 |
| Percent of Patients with Other Conditions Percentage of patients at hospice who had some other conditions as their primary diagnosis | 6 |
| Percent of Patients with Respiratory disease Percentage of patients at hospice who had Respiratory Disease as their primary diagnosis | 9 |
| Percent of Patients with Stroke Percentage of patients at hospice who had Stroke as their primary diagnosis | 12 |
| Provided Routine Home Care and other levels of care Th hospice had at least one incidence of routine home care and at least one more incidence of care at another level. Blank: hospice only provided care at routine home care level | Yes |
| Provided Routine Home Care only The hospice had at least one incidence of RHC over the 3 years, and no incidences of care at any other level. Blank: the hospice had at least one incidence of care at another level | No |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 23D0936161
- Facility Type
- Hospice
- Certificate Effective Date
- September 16, 2024
- Certificate Expiration Date
- September 15, 2026
- Laboratory Director
- SELECE L. BEASLEY
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Promedica Hospice (traverse City) to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1699728980, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 80. The final step is to find the difference between that total and the next multiple of ten (80 - 80 = 0).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 80 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 3 providers are registered at the same or a nearby location.
GRAND RAPIDS, MI 49546
GRAND RAPIDS, MI 49546
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1699728980, enumerated as an "organization" on May 18, 2006.
The provider is located at 695 KENMOOR AVE SE STE B GRAND RAPIDS, MI 49546 and the phone number is (616) 956-0636.
Hospice Care, Community Based with taxonomy code 251G00000X.
The provider might be accepting Accepts: Ambetter from Buckeye Health Plan, Ambetter from. Please consult your insurance carrier or call the provider to verify.
