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Address Healthcare of Michigan Pllc

Internal Medicine Physician in Grand Rapids, MI · enumerated 2024 · authorized official Jeffrey Wacksman, Authorized Official.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1043075294

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Registry record

Entity type Organization (Type 2)
Legal business name Address Healthcare of Michigan Pllc
Other name <Unavail>
Practice address 600 Monroe Avenue Nw, Ste 104, Grand Rapids, MI, 49503
Phone (616) 366-4234
Fax (855) 548-4481
Enumeration date Feb 16, 2024
Last updated in NPPES May 5, 2025

Taxonomy & classification

152W00000X Optometrist Eye and Vision Services Providers Secondary
207R00000X Internal Medicine Physician Allopathic & Osteopathic Physicians Primary
207RH0002X Hospice and Palliative Medicine (Internal Medicine) Physician Allopathic & Osteopathic Physicians Secondary
2084P0805X Geriatric Psychiatry Physician Allopathic & Osteopathic Physicians Secondary
213ES0103X Foot & Ankle Surgery Podiatrist Podiatric Medicine & Surgery Service Providers Secondary
363LA2200X Adult Health Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Secondary

Authorized official

Name Jeffrey Wacksman
Title Authorized Official
Phone (616) 366-4234

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Address Healthcare of Michigan Pllc?
The NPI for Address Healthcare of Michigan Pllc is 1043075294, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Address Healthcare of Michigan Pllc?
NPPES lists Jeffrey Wacksman (Authorized Official) as the authorized official for this organization.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2025-05-05.