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

Tracy L Mulder, PHYSICIANASSISTANT

Individual provider Physician Assistant · NPI 1477720423

Tracy L Mulder, PHYSICIANASSISTANT is a Physician Assistant in Grandville, Michigan. Qualified in 2008, 18 years ago. Practices with Advantage Health/Saint Mary's Medical Group, a 494-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
18
Licensed in
MI
In the registry since
2008
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Practice location Address checks out

3380 44th St SW
Grandville, MI 49418-2461
Phone: (616) 685-8250
Fax: (616) 532-3564
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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 5601005272 (MI)

Record details

NPI number1477720423
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHYSICIANASSISTANT
Sole proprietorNo
NPI enumeratedMay 9, 2008
Last updated in NPPESDecember 8, 2021
Certification dateDecember 8, 2021

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Advantage Health/Saint Mary'S Medical Group — 494 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Grandville