KEVIN J WIERSUM PAC
NPI 1699762765
Physician Assistant - Surgical in Grand Rapids, MI

Active since October 04, 2005PECOS EnrolledAccepts Medicare Assignment
70.14/100
CMS Quality Rating
1111 LEFFINGWELL AVE NE, STE 100, GRAND RAPIDS, MI 49525(616) 459-7101 Get Directions Write a Review

NPPES record last updated: September 18, 2013. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Kevin J Wiersum Pac NPPES

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

KEVIN J WIERSUM PAC (NPI 1699762765) is an individual surgical provider in Grand Rapids, Michigan, licensed in Michigan (5601004099) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS, is affiliated with Spectrum Health, and is a graduate of Other (2003).

NPPES Registry Identity

NPI1699762765
Entity TypeIndividualMale
Primary Taxonomy363AS0400X
Provider Legal NameKEVIN J WIERSUMCredential: PAC
Location Address1111 LEFFINGWELL AVE NE, STE 100Grand Rapids, MI 49525-6406
Mailing Address1111 Leffingwell Ave Ne, Ste 100Grand Rapids, MI 49525-6406 · (616) 459-7101
Sole ProprietorNo
Medical School CMSOtherGraduated 2003
Enumeration DateOctober 4, 2005
Last NPPES UpdateSeptember 18, 2013
NPI 1699762765 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License Licensed in MI · 5601004099
1111 LEFFINGWELL AVE NE, Grand Rapids, MI 49525

Other Identifiers 2

Medicare PINOP18140002
Medicare UPINQ00047

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

Kevin J Wiersum Pac 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 ID9436053808
PECOS Enrollment IDI20031126000397
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 10

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
39 services28 patients
Fusion of additional segment of spine 22614
Fusion of an additional segment of the spine is a surgical procedure to join two or more vertebrae together. This is done to stabilize the spine and reduce pain or correct a deformity. The procedure involves using bone grafts, rods, or screws to secure the spine.
37 services18 patients
X-ray of lower and sacral spine, minimum of 4 views 72110
An X-ray of the lower and sacral spine involves capturing images of your lower back and tailbone area. It helps in identifying issues like fractures, arthritis, or other abnormalities. At least four different angles or 'views' are taken to get a comprehensive picture.
30 services28 patients
Partial removal of spine bone with release of spinal cord and/or nerves, each additional segment 63048
This procedure involves the partial removal of a bone in your spine to alleviate pressure on your spinal cord or nerves. It may be performed on multiple spine segments depending on your condition. The aim is to improve mobility and reduce pain or discomfort.
28 services20 patients
X-ray of lower and sacral spine, 2-3 views 72100
An X-ray of the lower and sacral spine involves capturing images of your lower back area, including the tailbone. This procedure helps in identifying problems like fractures, infections, or deformities. 2-3 different angle views provide a comprehensive picture.
24 services21 patients
Partial removal of spine bone with release of lower spinal cord and/or nerves, 1 segment 63047
This procedure involves removing part of a spine bone to alleviate pressure on the lower spinal cord and/or nerves. It targets a single segment of the spine, improving mobility and reducing pain. It's a common treatment for conditions like herniated discs or spinal stenosis.
23 services23 patients

Hospital Affiliations CMS Care Compare 3

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

Spectrum Health

Acute Care Hospitals · Grand Rapids, MI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230038
Location100 Michigan St NEGrand Rapids, MI 49503 · Kent County
Emergency services Birthing friendly

Corewell Health Big Rapids Hospital

Acute Care Hospitals · Big Rapids, MI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230093
Location605 Oak StreetBig Rapids, MI 49307 · Mecosta County
Emergency services Birthing friendly

Corewell Health Pennock Hospital

Critical Access Hospitals · Hastings, MI
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number231339
Location1009 W Green StHastings, MI 49058 · Barry County
Emergency services Birthing friendly

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.

70.14/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality56.75
Promoting Interoperability62
Improvement Activities40
Cost75.4

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 (Surgical)
1111 LEFFINGWELL AVE NE
GRAND RAPIDS, MI 49525
Orthopaedic Surgery
1111 LEFFINGWELL AVE NE, SUITE 100
GRAND RAPIDS, MI 49525
Occupational Therapist
1111 LEFFINGWELL AVE NE, SUITE 200
GRAND RAPIDS, MI 49525
Orthopaedic Surgery
1111 LEFFINGWELL AVE NE
GRAND RAPIDS, MI 49525
Orthopaedic Surgery
1111 LEFFINGWELL AVE NE
GRAND RAPIDS, MI 49525
Orthopaedic Surgery (Hand Surgery)
1111 LEFFINGWELL AVE NE, SUITE 200
GRAND RAPIDS, MI 49525
Occupational Therapist
1111 LEFFINGWELL AVE NE, SUITE 200
GRAND RAPIDS, MI 49525
Physician Assistant (Surgical)
1111 LEFFINGWELL AVE NE, STE 100
GRAND RAPIDS, MI 49525

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 Kevin Wiersum's NPI number?

The NPI number for Kevin Wiersum is 1699762765. It was assigned to this individual provider in the NPPES registry on October 4, 2005.

Where is Kevin Wiersum located?

Kevin Wiersum practices at 1111 Leffingwell Ave NE Ste 100, Grand Rapids, MI 49525. The listed phone number is (616) 459-7101.

What is Kevin Wiersum's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Kevin Wiersum enrolled in Medicare?

Yes. Kevin Wiersum is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Kevin Wiersum accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Oscar Insurance Company and Priority Health list Kevin Wiersum 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.

Is Kevin Wiersum affiliated with any hospitals?

According to CMS data, Kevin Wiersum is affiliated with Spectrum Health, Corewell Health Big Rapids Hospital and Corewell Health Pennock Hospital.

When was this NPI record last updated?

The NPPES record for Kevin Wiersum was last updated on September 18, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.