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

Nicole M. Bossenbroek, MD

Individual provider Dermatopathology Physician · NPI 1619909611

Nicole M. Bossenbroek, MD is a Dermatology in Grand Rapids, Michigan. Graduated from Medical College of Wisconsin in 2002, 24 years ago. Practices with Derm Institute of West Michigan PLC, a 9-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
24
Trained at
Medical College of Wisconsin
Licensed in
MI
In the registry since
2006
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

6735 Cascade Rd SE Ste 300
Grand Rapids, MI 49546-8705
Phone: (269) 321-7546
Fax: (269) 321-1705
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatopathology Physician (primary) Taxonomy 207ND0900X · Licence 4301079716 (MI)

Record details

NPI number1619909611
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 7, 2006
Last updated in NPPESJuly 25, 2026
Certification dateJuly 25, 2026

Medicare enrollment

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

Medicare specialtyDERMATOLOGY
Also practisesPATHOLOGY
Medical schoolMEDICAL COLLEGE OF WISCONSIN
Graduated 2002 (24 years in practice)
Group practice Derm Institute Of West Michigan Plc — 9 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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