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

Melissa A Kooistra, PA

Individual provider Physician Assistant · NPI 1346260007

Melissa A Kooistra, PA is a Physician Assistant in Grand Rapids, Michigan. Qualified in 2004, 22 years ago. Accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
22
Licensed in
MI
In the registry since
2006
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

3940 Peninsular Dr SE Ste 230
Grand Rapids, MI 49546-6187
Phone: (616) 366-4234
Fax: (855) 548-4481
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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 5601004250 (MI)

Record details

NPI number1346260007
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJuly 19, 2006
Last updated in NPPESMay 15, 2025
Certification dateMay 15, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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