DR. LAURIE S BRAKER (MD) – Family Medicine Physician, NPI 1073624573

DR. LAURIE S BRAKER (MD) is a healthcare provider. based in Grand rapids, Michigan. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. 4301080130 (MI). The NPI Number for DR. LAURIE S BRAKER (MD) is 1073624573

Main info

Female
24 Years Of Experience
Accepts Medicare Assignment
Name
DR. LAURIE S BRAKER (MD)
NPI
1073624573
Phone
Not provided
Address
100 MICHIGAN ST NE # MC845
Enumeration Date
31 August 2006
Last Update Date
24 February 2021

Doctor Profile

Medical School Name
NORTHWESTERN UNIVERSITY FEINBERG MEDICAL SCHOOL
Secondary Phone
6163747660
Graduation Year
2002 (24 years ago)
PAC ID
0648216655
Group Practice PAC ID
4587551015
Professional Enrollment ID
I20050629001225
Address ID
MI488498430LA4294XDRXX300

Contacts

Secure Messaging
lbraker1091@epic00.shdirect.org
FHIR Endpoint
https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness85
Years active:19State licenses:1Other namesUpdated within 12 months

4,418 FAMILY PRACTICE in MI

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Provider Addresses for DR. LAURIE S BRAKER (MD)

  • 100 MICHIGAN ST NE # MC845

    GRAND RAPIDS, MI 495032560

    Phone:

    Type: Mailing

  • 4294, Laurel Drive, Odessa Township, Ionia County, Michigan, 48849, United States

    LAKE ODESSA, MI 488498430

    Phone: (616) 374-7660

    Fax: (616) 374-0270

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 12 Open Payments records for all available years, with a total value of $429.

Total Amount is formed as General ($429) + Research ($0) + Ownership ($0) = $429.

Last reported payment date: 2024-10-10 • Largest payer in this snapshot: Lilly USA, LLC ($152).

Total Amount

$429

General + Research + Ownership

Payments

12

Total payment records

General Amount

$429

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-10

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2005-06-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050629001225IFamily PracticeMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49503)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4587551015View full group profile
NameSpecialtyState
Nurse PractitionerMI
Certified Nurse Midwife (Cnm)MI
Family Practice, General PracticeMI
Physician AssistantMI
Nurse PractitionerMI
Nurse PractitionerMI
Orthopedic SurgeryMI
Nurse PractitionerMI
Nurse PractitionerMI
Physician AssistantMI

Reviews

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Frequently asked questions

Can I verify DR. LAURIE S BRAKER (MD) with an NPI only?
You can start verification with NPI 1073624573 for DR. LAURIE S BRAKER (MD), then check state licensing separately.
Can I rely on DR. LAURIE S BRAKER (MD) being an active provider?
As of the registry snapshot, DR. LAURIE S BRAKER (MD) is marked active.
What taxonomy line describes DR. LAURIE S BRAKER (MD)?
For research purposes, treat DR. LAURIE S BRAKER (MD) as Family Medicine Physician in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for DR. LAURIE S BRAKER (MD)?
DR. LAURIE S BRAKER (MD)'s geographic hint is Grand Rapids, Michigan in our summary view.
Is the information about DR. LAURIE S BRAKER (MD) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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