MICHIGAN PAIN CONSULTANTS PC – Pain Medicine (Anesthesiology) Physician, NPI 1467418574
Pain Medicine (Anesthesiology) Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for MICHIGAN PAIN CONSULTANTS PC
5555 GLENWOOD HILLS PKWY SE STE 2
GRAND RAPIDS, MI 495122091
Phone: (616) 940-2662
Fax: (616) 940-1965
Type: Mailing
2060, Paris Avenue Southeast, Third Ward, Grand Rapids, Kent County, Michigan, 49507, United States
SUITE 200
GRAND RAPIDS, MI 49546
Phone: (616) 285-1377
Fax: (616) 285-1006
Type: Location
61, Commerce Avenue Southwest, Grand Rapids, Kent County, Michigan, 49503, United States
GRAND RAPIDS, MI 49503
Phone: (616) 940-0660
Fax: (616) 940-1965
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: 2005-03-16
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2026-03-31 (71 days ago).
Enrollment records
1
Earliest due date
2026-03-31
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 |
|---|---|---|---|---|
| O20050316000695 | O | Clinic/Group Practice | MI | 2026-03-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 49512)
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