Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kenneth D Root, PA-C

Individual provider Physician Assistant · NPI 1053353946

Kenneth D Root, PA-C is a Physician Assistant in Grand Rapids, Michigan. Qualified in 2000, 26 years ago. Practices with Jean Talsma DO PLLC, a 4-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Michigan.

Years since qualifying
26
Licensed in
MI
In the registry since
2006
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1179 E Paris Ave SE Ste 150
Grand Rapids, MI 49546-8373
Phone: (616) 455-9450
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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 5601003447 (MI)

Record details

NPI number1053353946
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 12, 2006
Last updated in NPPESMay 14, 2026
Certification dateMay 14, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2000 (26 years in practice)
Group practice Jean Talsma Do Pllc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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