MYKALA PARIS SUPPLICE PAC
NPI 1790209070
Physician Assistant in Grand Rapids, MI
About Mykala Paris Supplice Pac NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MYKALA PARIS SUPPLICE PAC (NPI 1790209070) is an individual physician assistant in Grand Rapids, Michigan, licensed in Michigan (5601011723) and active in the NPI registry since July 2017. She is enrolled in Medicare PECOS, is affiliated with Spectrum Health, and is a graduate of Other (2023).
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 and accepts Medicare assignment
Mykala Paris Supplice 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.
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, MICorewell Health Big Rapids Hospital
Acute Care Hospitals · Big Rapids, MICorewell Health Pennock Hospital
Critical Access Hospitals · Hastings, MIPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 49506 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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 49506
GRAND RAPIDS, MI 49506
GRAND RAPIDS, MI 49506
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 Mykala Supplice's NPI number?
The NPI number for Mykala Supplice is 1790209070. It was assigned to this individual provider in the NPPES registry on July 28, 2017.
Where is Mykala Supplice located?
Mykala Supplice practices at 1900 Wealthy St SE Ste 300, Grand Rapids, MI 49506. The listed phone number is (616) 774-8345.
What is Mykala Supplice's specialty?
The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.
Is Mykala Supplice enrolled in Medicare?
Yes. Mykala Supplice 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 Mykala Supplice accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and Priority Health list Mykala Supplice 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 Mykala Supplice affiliated with any hospitals?
According to CMS data, Mykala Supplice 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 Mykala Supplice was last updated on March 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Mykala Paris Supplice, PAC · NPI 1790209070
Physician Assistant physician in Grand Rapids, Michigan. Individual provider, active in the CMS NPPES registry since July 28, 2017.
## Identity
- **NPI:** 1790209070 (Entity type: Individual)
- **Enumerated:** July 28, 2017
- **Primary specialty:** Physician Assistant · taxonomy 363A00000X
- **State license:** 5601011723 (Michigan)
- **Sole proprietor:** No
## Practice location
- **Address:** 1900 WEALTHY ST SE STE 300, Grand Rapids, MI 49506-2969
- **Phone:** (616) 774-8345
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2023
## Record status
- **NPPES last updated:** March 25, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1790209070) · Data from the CMS NPPES public registry.