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

Kelly Michelle McGillicuddy, PA

Individual provider Physician Assistant · NPI 1437679487

Kelly Michelle McGillicuddy, PA is a Physician Assistant in Grand Rapids, Michigan. Qualified in 2017, 9 years ago. Practices with Spectrum Health Primary Care Partners, a 2,303-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Michigan.

Years since qualifying
9
Licensed in
MI
In the registry since
2017
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

2750 E Beltline Ave NE
Grand Rapids, MI 49525-8614
Phone: (616) 267-7015
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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 5601008325 (MI)

Record details

NPI number1437679487
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJune 21, 2017
Last updated in NPPESMay 23, 2022
Certification dateMay 23, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Spectrum Health Primary Care Partners — 2303 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations6 on file with Medicare

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