DR. KELLY WIERSEMA MD
NPI 1902023575
Obstetrics & Gynecology in Grand Rapids, MI

Active since April 18, 2007PECOS EnrolledAccepts Medicare Assignment
200 JEFFERSON AVE SE, GRAND RAPIDS, MI 49503(616) 685-6501 Get Directions Write a Review

NPPES record last updated: October 10, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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

NPI1902023575
Entity TypeIndividualFemale
Primary Taxonomy207V00000X
Provider Legal NameDR. KELLY WIERSEMACredential: MD
Location Address200 JEFFERSON AVE SEGrand Rapids, MI 49503-4502
Mailing Address1900 44th St SeKentwood, MI 49508-5008
Sole ProprietorNo
Medical School CMSWayne State University School Of MedicineGraduated 2005
Enumeration DateApril 18, 2007
Last NPPES UpdateOctober 10, 2016
NPI 1902023575 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
License Licensed in MI · 4301086392
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
200 JEFFERSON AVE SE, Grand Rapids, MI 49503

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

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.

PECOS PAC ID3678627437
PECOS Enrollment IDI20090813000700
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.

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.

New Patient
$126.15 typical visit price
range $54.34 – $166.68
Typical copayment $31.53 (range $13.58 – $41.67)
Most-billed visit code 99204
Established Patient
$68.07 typical visit price
range $17.09 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

Physical Therapist
200 JEFFERSON AVE SE
GRAND RAPIDS, MI 49503
Nurse Anesthetist, Certified Registered
200 JEFFERSON AVE SE
GRAND RAPIDS, MI 49503
Emergency Medicine
200 JEFFERSON AVE SE
GRAND RAPIDS, MI 49503
Pediatrics (Neonatal-Perinatal Medicine)
200 JEFFERSON AVE SE, NICU
GRAND RAPIDS, MI 49503
Durable Medical Equipment & Medical Supplies
200 JEFFERSON AVE SE
GRAND RAPIDS, MI 49503
Occupational Therapist
200 JEFFERSON AVE SE
GRAND RAPIDS, MI 49503
Nurse Practitioner (Family)
200 JEFFERSON AVE SE
GRAND RAPIDS, MI 49503
Registered Nurse
200 JEFFERSON AVE SE
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.

What insurance does Kelly Wiersema accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community, Oscar Insurance Company and Priority Health 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 9 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.