DR. KELLY WIERSEMA MD
NPI 1902023575
Obstetrics & Gynecology in Grand Rapids, MI
About Dr. Kelly Wiersema Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. KELLY WIERSEMA MD (NPI 1902023575) is an individual obstetrics & gynecology provider in Grand Rapids, Michigan, licensed in Michigan (4301086392) and active in the NPI registry since April 2007. She is enrolled in Medicare PECOS and is a graduate of Wayne State University School Of Medicine (2005).
NPPES Registry Identity
Specialties & Licenses
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
Dr. Kelly Wiersema Md 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.
Medicare Billing Reassignments
3Medicare enrollment records show Kelly Wiersema reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Grand Rapids, MI 49503
- Reassigned Medicare billing, Michigan enrollment
- 737 clinicians in this Medicare group
Muskegon, MI 49442
- Reassigned Medicare billing, Michigan enrollment
- 150 clinicians in this Medicare group
Muskegon, MI 49442
- Reassigned Medicare billing, Michigan enrollment
- 23 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 49503 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 49503
GRAND RAPIDS, MI 49503
GRAND RAPIDS, MI 49503
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 Kelly Wiersema's NPI number?
The NPI number for Kelly Wiersema is 1902023575. It was assigned to this individual provider in the NPPES registry on April 18, 2007.
Where is Kelly Wiersema located?
Kelly Wiersema practices at 200 Jefferson Ave SE, Grand Rapids, MI 49503. The listed phone number is (616) 685-6501.
What is Kelly Wiersema's specialty?
The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.
Is Kelly Wiersema enrolled in Medicare?
Yes. Kelly Wiersema 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 organizations bill Medicare for Kelly Wiersema's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Wiersema reassigns Medicare benefits to 3 organizations: Advantage Health Saint Mary's Medical Group (Grand Rapids, MI), Mercy Health Partners - Physician Specialist (Muskegon, MI) and Mercy Women's Health Services (Muskegon, MI). Each 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 Kelly Wiersema's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kelly Wiersema accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 2 other insurers list Kelly Wiersema 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 Kelly Wiersema was last updated on October 10, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.
# Dr. Kelly Wiersema, MD · NPI 1902023575
Obstetrics & Gynecology physician in Grand Rapids, Michigan. Individual provider, active in the CMS NPPES registry since April 18, 2007.
## Identity
- **NPI:** 1902023575 (Entity type: Individual)
- **Enumerated:** April 18, 2007
- **Primary specialty:** Obstetrics & Gynecology · taxonomy 207V00000X
- **State license:** 4301086392 (Michigan)
- **Sole proprietor:** No
## Practice location
- **Address:** 200 JEFFERSON AVE SE, Grand Rapids, MI 49503-4502
- **Phone:** (616) 685-6501
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Advantage Health Saint Mary's Medical Group (NPI 1952340911, Grand Rapids, MI); Mercy Health Partners - Physician Specialist (NPI 1922248772, Muskegon, MI); Mercy Women's Health Services (NPI 1467476143, Muskegon, MI) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Wayne State University School Of Medicine, class of 2005
## Record status
- **NPPES last updated:** October 10, 2016
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Source: [NPI Profile](https://npiprofile.com/npi/1902023575) · Data from the CMS NPPES public registry.