TRICIA M MIEDEMA (MD) – Emergency Medicine Physician, NPI 1023390507
Emergency Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,158 EMERGENCY MEDICINE in MI
Provider Addresses for TRICIA M MIEDEMA (MD)
901 ADAMS ST
AFTON, WY 831109621
Phone: (307) 885-5800
Type: Mailing
200 N PARK ST
KALAMAZOO, MI 490073731
Phone: (269) 382-2500
Fax: (269) 373-0123
Type: Mailing
1625 N CAMPBELL AVE
TUCSON, AZ 857194330
Phone: (520) 626-7233
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: 2025-07-03
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 |
|---|---|---|---|---|
| I20250703001194 | I | Emergency Medicine | WY | 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 83110)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Therapist In Private Practice | WY | |
| - | WY | |
| A N E S T H E S I O L O G Y | UT | |
| Family Practice | WY | |
| Cardiovascular Disease (Cardiology), Interventional Cardiology | ID | |
| Physician Assistant | WA | |
| Emergency Medicine | WY | |
| Family Practice | WY | |
| Physician Assistant | IA | |
| Physician Assistant | IL |
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