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Deactivated NPI 1659324879 Deactivated / Inactive NPI Male Practitioner

John Denboer , PA-C

Physician Assistant • Grand Rapids, MI

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, John Denboer has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date May 18, 2006
NPI Deactivation Date May 10, 2023
Total Practice Duration ~17 Years of Practice (2006 – 2023)

Professional Overview & Biography Verified Profile Summary

John Denboer, PA-C was a registered Physician Assistant practicing in Grand Rapids, MI. Throughout an active medical career spanning 17 years, John Denboer provided care at the practice location at 245 STATE ST SE until profile deactivation on 2023-05-10.

Practice Location & Contact Primary Location

Practice Address

245 State St Se

Grand Rapids, MI 495034328

Telephone 6166851800
Fax 6166851818
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Grand Rapids, MI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 11.4 Yrs
State Avg: 12.2 Yrs
Regional Practice Density
920 Specialists

Practicing in Grand Rapids, MI (7057 Statewide)

Telehealth Adoption Rate
17.8% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License MI 5601001839

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
Dr. Pamela Wirth , MD

Family Medicine

NPI 1073566071

Doctor of Medicine (M.D.)

Dr. Kerry Polizzi , MD

Family Medicine

NPI 1508819517

Doctor of Medicine (M.D.)

Lisa Lerond , PA-C

Physician Assistant

NPI 1699720730

Physician Assistant (Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated May 10, 2023

Record deactivated on May 10, 2023

NPI Profile Active June 26, 2009

NPI status registered as active in NPPES database

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Updated Practice Location June 26, 2009

Registered at 245 STATE ST SE, GRAND RAPIDS, MI 495034328 (Tel: 6166851800)

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Updated Business Mailing Address June 26, 2009

Registered at 245 STATE ST SE, GRAND RAPIDS, MI 495034328 (Tel: 6166851808)

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Provider Name / Credentials Updated June 26, 2009

Recorded as JOHN DENBOER, PA-C

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Medical Taxonomy / Specialty Registered (Primary Specialty) June 26, 2009

Physician Assistant (License #5601001839 in MI)

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Initial NPI Registration & Enumeration May 18, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1659324879
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 18, 2006
Last Update: June 26, 2009
Deactivation Date: May 10, 2023

Mailing Address

245 State St Se

Grand Rapids, MI 495034328

Phone: 6166851808

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.