PAULINA LYNN VANTIMMEREN (PA-C) – Physician Assistant, NPI 1659157741
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
6,066 PHYSICIAN ASSISTANT in MI
Provider Addresses for PAULINA LYNN VANTIMMEREN (PA-C)
942 BENJAMIN AVE SE
GRAND RAPIDS, MI 495063221
Phone: (616) 460-4548
Type: Mailing
2060 E PARIS AVE SE STE 100
GRAND RAPIDS, MI 495466113
Phone: (616) 460-4548
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 17 Open Payments records for all available years, with a total value of $339.
Total Amount is formed as General ($339) + Research ($0) + Ownership ($0) = $339.
Last reported payment date: 2024-12-06 • Largest payer in this snapshot: Novo Nordisk Inc ($279).
Total Amount
$339
General + Research + Ownership
Payments
17
Total payment records
General Amount
$339
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-06
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Novo Nordisk Inc | $279 |
| Lilly USA, LLC | $60 |
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: 2023-09-25
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20230925002869 | I | Physician Assistant | MI | TBD |
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.
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 49506)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | MI | |
| Physician Assistant | MI | |
| General Surgery | MI | |
| Physician Assistant | MI | |
| Internal Medicine | MI | |
| General Surgery | MI | |
| - | MI | |
| Physician Assistant | MI | |
| - | AZ | |
| General Surgery | MI |
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