LIANA DYKEMA – Psychiatric/Mental Health Nurse Practitioner, NPI 1154202786

LIANA DYKEMA is a healthcare provider. based in Holland, Michigan. specializing in NURSE PRACTITIONER. They hold a License No. 4704374209 (MI). The NPI Number for LIANA DYKEMA is 1154202786

Main info

Female
1 Year Of Experience
Accepts Medicare Assignment
Name
LIANA DYKEMA
NPI
1154202786
Phone
(616) 952-9957
Address
400 136TH AVE STE 416
Enumeration Date
10 September 2025
Last Update Date
30 December 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6169529957
Graduation Year
2025 (1 year ago)
PAC ID
3173014743
Group Practice PAC ID
6103238167
Professional Enrollment ID
I20251112002010
Address ID
MI494242905HO400XXAVEX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

8,106 NURSE PRACTITIONER in MI

Provider Addresses for LIANA DYKEMA

  • 400 136TH AVE STE 416

    HOLLAND, MI 494242905

    Phone: (616) 952-9957

    Fax: (616) 369-1400

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2025-11-12

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
I20251112002010INurse PractitionerMITBD

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 49424)

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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: 6103238167View full group profile
NameSpecialtyState
Clinical PsychologistMI
Clinical PsychologistMI
Clinical Social WorkerMI
Mental Health CounselorMI
Clinical Social WorkerMI
Clinical Social WorkerIN
Clinical Social WorkerMI

Reviews

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Frequently asked questions

Where can patients find LIANA DYKEMA's NPI?
You can confirm LIANA DYKEMA with NPI 1154202786; it appears in the national provider directory.
Is LIANA DYKEMA active in the national directory?
LIANA DYKEMA's public NPI profile is in an active state.
What kind of provider is LIANA DYKEMA?
The page reflects Psychiatric/Mental Health Nurse Practitioner for LIANA DYKEMA. Clinical services aligned with this taxonomy classification.
Where is LIANA DYKEMA's primary listing?
We display Holland, Michigan because that is what the record indicates for LIANA DYKEMA.
Is LIANA DYKEMA a real provider?
This page reflects official NPPES data for NPI 1154202786. Always confirm identity and privileges with the practice and licensing boards.

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