JILL MIEDEMA (MD) – Family Medicine Physician, NPI 1083737969

JILL MIEDEMA (MD) is a healthcare provider. based in Grand haven, Michigan. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. 51202 (MN). The NPI Number for JILL MIEDEMA (MD) is 1083737969

Main info

Female
21 Years Of Experience
Accepts Medicare Assignment
Name
JILL MIEDEMA (MD)
NPI
1083737969
Phone
(517) 803-9493
Address
17581 DUNESIDE DR
Enumeration Date
7 April 2007
Last Update Date
30 July 2012

Doctor Profile

Medical School Name
MICHIGAN STATE UNIVERSITY COLLEGE OF HUMAN MEDICINE
Secondary Phone
6163966516
Graduation Year
2005 (21 years ago)
PAC ID
6901981471
Group Practice PAC ID
0749290740
Professional Enrollment ID
I20080307000210
Address ID
MI494242169HO382XXAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

4,418 FAMILY PRACTICE in MI

Provider Addresses for JILL MIEDEMA (MD)

  • 17581 DUNESIDE DR

    GRAND HAVEN, MI 494178883

    Phone: (517) 803-9493

    Type: Mailing

  • 382 120TH AVE

    HOLLAND, MI 494242169

    Phone: (616) 396-6516

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 5 Open Payments records for all available years, with a total value of $116.

Total Amount is formed as General ($116) + Research ($0) + Ownership ($0) = $116.

Last reported payment date: 2024-12-10 • Largest payer in this snapshot: PFIZER INC. ($72).

Total Amount

$116

General + Research + Ownership

Payments

5

Total payment records

General Amount

$116

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-10

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: 2008-03-07

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
I20080307000210IFamily 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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes9548$0
96372Injection of drug or substance under skin or into muscle2620$0
83036Hemoglobin a1c level2214$0
99213Established patient office or other outpatient visit, 20-29 minutes1413$0
View full utilization report →

Insurance plans in this area (ZIP 49417)

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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: 0749290740View full group profile
NameSpecialtyState
Nurse PractitionerMI
Family PracticeMI
Family PracticeMI
Nurse PractitionerMI
Family PracticeMI
Nurse PractitionerMI
Family PracticeMI
Family PracticeMI
Family PracticeMI
Family PracticeMI

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

How do I look up JILL MIEDEMA (MD) by NPI?
Use NPI 1083737969 when you need to reference JILL MIEDEMA (MD) in forms, claims, or directories.
Is JILL MIEDEMA (MD)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does JILL MIEDEMA (MD) list a primary specialty?
If you are matching referrals, note Family Medicine Physician for JILL MIEDEMA (MD). Clinical services aligned with this taxonomy classification.
Where is JILL MIEDEMA (MD)'s primary listing?
We display Grand Haven, Michigan because that is what the record indicates for JILL MIEDEMA (MD).
How can I contact JILL MIEDEMA (MD)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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