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Anina L Cicerone-Carder

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

25 Michigan St NE, Suite 6100, Grand Rapids, MI 49503-2515

PECOS Enrollment

This provider is enrolled in PECOS as ANINA CICERONE-CARDER.

Based on the most recent information from CMS, provider Anina L Cicerone-Carder is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 4 days ago.

Profile Details

Provider ID
1457803751
Provider Type
Individual
Full Name
Cicerone-Carder, Anina L
Credential
PA-C

Gender
Female
Sole Proprietor
No
Enumeration Date
11/3/2016
Last Updated
9/24/2021

Contact Information

Practice Location

25 Michigan St NE, Suite 6100, Grand Rapids, MI 49503-2515

(616) 267-7900

(616) 267-7901

Mailing Location

100 Michigan St NE, Mc 845, Grand Rapids, MI 49503-2560

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 5601008066 Michigan

Anina L Cicerone-Carder

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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