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

Halli Disbrow

Individual provider Physician Assistant · NPI 1215510862

Halli Disbrow is a Physician Assistant in Grand Rapids, Michigan. Qualified in 2025, 1 year ago. Licensed in Michigan.

Years since qualifying
1
Licensed in
MI
In the registry since
2021
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Practice location Address checks out

3500 Lake Dr SE
Grand Rapids, MI 49546-4310
Phone: (616) 475-7577
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601013927 (MI)

Record details

NPI number1215510862
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 2, 2021
Last updated in NPPESMay 7, 2026
Certification dateMay 7, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated

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