CARRIE RUTH ROBERSON (PA) – Physician Assistant, NPI 1346248564

CARRIE RUTH ROBERSON (PA) is a healthcare provider. based in Grand haven, Michigan. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. 5601003155 (MI). The NPI Number for CARRIE RUTH ROBERSON (PA) is 1346248564

Main info

Female
27 Years Of Experience
Accepts Medicare Assignment
Name
CARRIE RUTH ROBERSON (PA)
NPI
1346248564
Phone
(616) 935-6320
Address
15100 WHITTAKER WAY
Enumeration Date
12 July 2005
Last Update Date
28 July 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1999 (27 years ago)
PAC ID
3870573090
Group Practice PAC ID
0446157291
Professional Enrollment ID
I20040720001110
Address ID
MI494172654GR1600XBLVD400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

6,069 PHYSICIAN ASSISTANT in MI

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Provider Addresses for CARRIE RUTH ROBERSON (PA)

  • 15100, Whittaker Way, Grand Haven, Grand Haven Charter Township, Ottawa County, Michigan, 49417, United States

    GRAND HAVEN, MI 494178696

    Phone: (616) 935-6320

    Type: Location

  • 1600 S BEACON BLVD

    GRAND HAVEN, MI 494172654

    Phone: (616) 344-1033

    Type: Mailing

  • Spectrum Health Butterworth Hospital, 100, Michigan Street Northeast, Grand Rapids, Kent County, Michigan, 49503, United States

    MC845

    GRAND RAPIDS, MI 495032560

    Phone:

    Type: Mailing

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: 2004-07-20

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
I20040720001110IPhysician AssistantMITBD

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 minutes3819$0
99213Established patient office or other outpatient visit, 20-29 minutes2114$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit1313$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: 0446157291View full group profile

Reviews

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Frequently asked questions

What is CARRIE RUTH ROBERSON (PA)'s NPI number?
CARRIE RUTH ROBERSON (PA)'s NPI is 1346248564 — the number used across U.S. healthcare to identify this provider.
Is there an active status for CARRIE RUTH ROBERSON (PA)?
For scheduling context, CARRIE RUTH ROBERSON (PA) is shown as active in the registry.
What area of care is associated with CARRIE RUTH ROBERSON (PA)?
CARRIE RUTH ROBERSON (PA)'s record emphasizes Physician Assistant. Clinical services aligned with this taxonomy classification.
Is CARRIE RUTH ROBERSON (PA) associated with Grand Haven?
Public fields place CARRIE RUTH ROBERSON (PA) around Grand Haven, Michigan. Always confirm the exact site before visiting.
Can I trust this NPI listing for CARRIE RUTH ROBERSON (PA)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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