THEODORA RUXANDRA NAE PA
NPI 1780929018
Physician Assistant in Grand Rapids, MI
About Theodora Ruxandra Nae Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
THEODORA RUXANDRA NAE PA (NPI 1780929018) is an individual physician assistant in Grand Rapids, Michigan, licensed in Michigan (5601006369) and active in the NPI registry since November 2012. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
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 (PECOS)
Theodora Ruxandra Nae Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 49546 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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.
GRAND RAPIDS, MI 49546
GRAND RAPIDS, MI 49546
GRAND RAPIDS, MI 49546
GRAND RAPIDS, MI 49546
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 Theodora Nae's NPI number?
The NPI number for Theodora Nae is 1780929018. It was assigned to this individual provider in the NPPES registry on November 27, 2012.
Where is Theodora Nae located?
Theodora Nae practices at 4100 Lake Dr SE, Grand Rapids, MI 49546. The listed phone number is (616) 267-7414.
What is Theodora Nae's specialty?
The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.
Is Theodora Nae enrolled in Medicare?
Yes. Theodora Nae is registered in the Medicare PECOS enrollment system.
What insurance does Theodora Nae accept?
Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and Priority Health list Theodora Nae 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 Theodora Nae was last updated on December 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.
# Theodora Ruxandra Nae, PA · NPI 1780929018
Physician Assistant physician in Grand Rapids, Michigan. Individual provider, active in the CMS NPPES registry since November 27, 2012.
## Identity
- **NPI:** 1780929018 (Entity type: Individual)
- **Enumerated:** November 27, 2012
- **Primary specialty:** Physician Assistant · taxonomy 363A00000X
- **State license:** 5601006369 (Michigan)
- **Sole proprietor:** No
## Practice location
- **Address:** 4100 LAKE DR SE, Grand Rapids, MI 49546-8292
- **Phone:** (616) 267-7414
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** December 12, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1780929018) · Data from the CMS NPPES public registry.