Address Healthcare of Michigan PLLC
NPI 1043075294 · Internal Medicine Physician · Grand Rapids, MI
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Address Healthcare of Michigan PLLC is a Internal Medicine Physician organization in Grand Rapids, MI (NPI 1043075294).
Provider details
- NPI number
- 1043075294
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jeffrey Wacksman, Authorized Official(616) 366-4234
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Optometrist152W00000X
Eye and Vision Services Providers
Allopathic & Osteopathic Physicians
- Geriatric Psychiatry Physician2084P0805X
Allopathic & Osteopathic Physicians
- Foot & Ankle Surgery Podiatrist213ES0103X
Podiatric Medicine & Surgery Service Providers
- Adult Health Nurse Practitioner363LA2200X
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Address Healthcare
- Doing business as
- Address Healthcare
- Doing business as
- Address Healthcare of Michigan
Registry dates
- Enumerated
- 2024-02-16
- Last updated
- 2025-05-05
- Certified
- 2025-04-18
Frequently asked questions
- What is Address Healthcare of Michigan PLLC's NPI number?
- Address Healthcare of Michigan PLLC's National Provider Identifier (NPI) is 1043075294, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Address Healthcare of Michigan PLLC?
- Address Healthcare of Michigan PLLC is classified in the NPPES registry as Internal Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Address Healthcare of Michigan PLLC located?
- Address Healthcare of Michigan PLLC's practice location on file with NPPES is 600 Monroe Avenue Nw, Grand Rapids, MI 49503-1470.
- What is Address Healthcare of Michigan PLLC's phone number?
- The practice phone number listed in the NPPES registry for Address Healthcare of Michigan PLLC is (616) 366-4234.
- Does Address Healthcare of Michigan PLLC accept Medicare?
- Address Healthcare of Michigan PLLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Address Healthcare of Michigan PLLC?
- The authorized official listed on Address Healthcare of Michigan PLLC's NPPES record is Jeffrey Wacksman, Authorized Official. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Address Healthcare of Michigan PLLC's NPI active?
- Yes — Address Healthcare of Michigan PLLC's NPI (1043075294) is active in the NPPES registry as of the last update on 2025-05-05.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.