Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Andrew Hallett, MD

Individual provider Surgery Physician · NPI 1477006591

Andrew Hallett, MD is a Colorectal Surgery (Proctology) in Grand Rapids, Michigan. Qualified in 2017, 9 years ago. Practices with St Lukes Clinic-Treasure Valley LLC, a 1,150-clinician group and accepts Medicare assignment. Licensed in Idaho, Michigan and Pennsylvania.

Years since qualifying
9
Licensed in
ID, MI, PA
In the registry since
2016
Specialties on file
4
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

4100 Lake Dr SE Ste 205
Grand Rapids, MI 49546-8292
Phone: (616) 267-7100
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 9271076 (ID)
Surgery Physician Taxonomy 208600000X · Licence 4301512108 (MI)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X
Surgery Physician Taxonomy 208600000X · Licence MT213958 (PA)

Record details

NPI number1477006591
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedJuly 25, 2016
Last updated in NPPESOctober 28, 2025
Certification dateOctober 28, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCOLORECTAL SURGERY (PROCTOLOGY)
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice St Lukes Clinic-Treasure Valley Llc — 1150 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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