PINE REST CHRISTIAN MENTAL HEALTH SERVICES
NPI 1922019157
Social Worker in Grand Rapids, MI
About Pine Rest Christian Mental Health Services NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PINE REST CHRISTIAN MENTAL HEALTH SERVICES (NPI 1922019157) is a healthcare organization registered as a social worker in Grand Rapids, Michigan and active in the NPI registry since August 2006. The organization lists Diane Fennema, Managed Care Administrator, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Pine Rest Christian Mental Health Services is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by November 30, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
260Medicare enrollment records show 260 clinicians reassign Medicare billing to Pine Rest Christian Mental Health Services, which bills Medicare for the services they deliver. Of these, 24 practice at this address and 150 within 10 miles. Listed here are the 20 practicing nearest to this location.
Nearest to this location (20)
See all 260Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Pine Rest Christian Mental Health Services's NPI number?
The NPI number for Pine Rest Christian Mental Health Services is 1922019157. It was assigned to this organization in the NPPES registry on August 11, 2006.
Where is Pine Rest Christian Mental Health Services located?
Pine Rest Christian Mental Health Services is located at 300 68th St SE, Grand Rapids, MI 49548. The listed phone number is (616) 455-5000.
What is Pine Rest Christian Mental Health Services's specialty?
The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.
Is Pine Rest Christian Mental Health Services enrolled in Medicare?
Yes. Pine Rest Christian Mental Health Services is registered in the Medicare PECOS enrollment system.
When is Pine Rest Christian Mental Health Services's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Michigan, Clinic/Group Practice) is due for revalidation by November 30, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Pine Rest Christian Mental Health Services?
According to the CMS Revalidation Reassignment List (October 2026 release), 260 clinicians, all in Clinical Social Worker, reassign their Medicare billing to Pine Rest Christian Mental Health Services. A 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 the clinician's services. Of these, 24 practice at this address and 150 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Pine Rest Christian Mental Health Services 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 list Pine Rest Christian Mental Health Services 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 Pine Rest Christian Mental Health Services was last updated on September 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.
# Pine Rest Christian Mental Health Services · NPI 1922019157
Social Worker organization in Grand Rapids, Michigan. Organization record, active in the CMS NPPES registry since August 11, 2006.
## Identity
- **NPI:** 1922019157 (Entity type: Organization)
- **Enumerated:** August 11, 2006
- **Primary specialty:** Social Worker · taxonomy 104100000X
- **Organization subpart:** Yes (part of Pine Rest Christian Mental Health Services)
- **Authorized official:** Diane Fennema, MANAGED CARE ADMINISTRATOR
## Practice location
- **Address:** 300 68TH ST SE, Grand Rapids, MI 49548-6927
- **Phone:** (616) 455-5000
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** November 30, 2026 (Non-DME Part B, Michigan, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 260 clinicians (Clinical Social Worker) reassign Medicare billing to this organization (form CMS-855R); 24 practice at this address and 150 within 10 miles; [full list](https://npiprofile.com/npi/1922019157/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 23, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1922019157) · Data from the CMS NPPES public registry.