ASHLEY SUSAN TIEMEYER THEISEN (PA-C) – Physician Assistant, NPI 1770103210
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
6,066 PHYSICIAN ASSISTANT in MI
Provider Addresses for ASHLEY SUSAN TIEMEYER THEISEN (PA-C)
602 MICHIGAN AVE STE 102
HOLLAND, MI 494234918
Phone: (616) 494-8724
Type: Location
5898 MADISON AVE SE
KENTWOOD, MI 495486862
Phone:
Type: Mailing
1525 E BELTLINE AVE NE STE 101
GRAND RAPIDS, MI 495254598
Phone: (616) 447-8220
Type: Location
100 MICHIGAN ST NE # 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)
CMS reports 11 Open Payments records for all available years, with a total value of $228.
Total Amount is formed as General ($228) + Research ($0) + Ownership ($0) = $228.
Last reported payment date: 2023-09-13 • Largest payer in this snapshot: Kiniksa Pharmaceuticals, Ltd. ($44).
Total Amount
$228
General + Research + Ownership
Payments
11
Total payment records
General Amount
$228
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-09-13
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Kiniksa Pharmaceuticals, Ltd. | $44 |
| Amgen Inc. | $42 |
| Novo Nordisk Inc | $24 |
| Abbott Laboratories | $20 |
| Novartis Pharmaceuticals Corporation | $19 |
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: 2020-08-11
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 |
|---|---|---|---|---|
| I20200811001833 | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 119 | 106 | $0 |
| 93000 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report | 50 | 46 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 24 | 23 | $0 |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 21 | 11 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 13 | 13 | $0 |
Insurance plans in this area (ZIP 49423)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Critical Care (Intensivists) | IL | |
| Physician Assistant | MI | |
| Physician Assistant | MI | |
| Physician Assistant | MI | |
| - | MI | |
| Vascular Surgery | IL | |
| - | MI | |
| - | MI | |
| A N E S T H E S I O L O G Y | TX | |
| Clinical Social Worker | MI |
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