KIMBERLEE JEAN PROSE PSY.D.
NPI 1861428161
Psychologist in Grand Rapids, MI

Active since June 25, 2006PECOS EnrolledAccepts Medicare Assignment
933 3 MILE RD NW, GRAND RAPIDS, MI 49544(616) 222-3720 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Kimberlee Jean Prose Psy.d. NPPES

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

KIMBERLEE JEAN PROSE PSY.D. (NPI 1861428161) is an individual psychologist in Grand Rapids, Michigan, licensed in Michigan (6301010702) and active in the NPI registry since June 2006. She is enrolled in Medicare PECOS and is a graduate of Other (1983).

NPPES Registry Identity

NPI1861428161
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameKIMBERLEE JEAN PROSECredential: PSY.D.
Location Address933 3 MILE RD NWGrand Rapids, MI 49544-1673
Mailing Address300 68th St SeGrand Rapids, MI 49548-6927 · (616) 455-5000
Sole ProprietorNo
Medical School CMSOtherGraduated 1983
Enumeration DateJune 25, 2006
Last NPPES UpdateJuly 13, 2026
✔ NPI 1861428161 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License✔ Licensed in MI · 6301010702
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
933 3 MILE RD NW, Grand Rapids, MI 49544

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kimberlee Jean Prose Psy.d. 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 ID4082632880
PECOS Enrollment IDI20051110000286
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 Kimberlee Prose reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Professional
300 68TH ST SE
Grand Rapids, MI 49548
  • Reassigned Medicare billing, Michigan enrollment
  • 135 clinicians in this Medicare group

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

Other Providers at the Same Location NPPES 14

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

Clinic/Center (Health Service)
933 3 MILE RD NW, SUITE 110
GRAND RAPIDS, MI 49544
Family Medicine
933 3 MILE RD NW, SUITE 210
WALKER, MI 49544
Physician Assistant
933 3 MILE RD NW, SUITE 210
WALKER, MI 49544
Physician Assistant
933 3 MILE RD NW, STE 210
WALKER, MI 49544
Nurse Practitioner
933 3 MILE RD NW
GRAND RAPIDS, MI 49544
Social Worker
933 3 MILE RD NW
GRAND RAPIDS, MI 49544
Clinic/Center (Urgent Care)
933 3 MILE RD NW, SUITE 110
GRAND RAPIDS, MI 49544
Family Medicine
933 3 MILE RD NW, SUITE 210
GRAND RAPIDS, MI 49544

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 Kimberlee Prose's NPI number?

The NPI number for Kimberlee Prose is 1861428161. It was assigned to this individual provider in the NPPES registry on June 25, 2006.

Where is Kimberlee Prose located?

Kimberlee Prose practices at 933 3 Mile Rd NW, Grand Rapids, MI 49544. The listed phone number is (616) 222-3720.

What is Kimberlee Prose's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Kimberlee Prose enrolled in Medicare?

Yes. Kimberlee Prose 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.

Which organization bills Medicare for Kimberlee Prose's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kimberlee Prose reassigns Medicare benefits to Pine Rest Christian Mental Health Services (Grand Rapids, 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 Kimberlee Prose's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kimberlee Prose accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and Priority Health list Kimberlee Prose 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 Kimberlee Prose was last updated on July 13, 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.