Look up the most recent NPI and PECOS records

William R Breese

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

35 Michigan NE, Suite 4150, Grand Rapids, MI 49503

PECOS Enrollment

This provider is enrolled in PECOS as WILLIAM BREESE.

Based on the most recent information from CMS, provider William R Breese is legally eligible to order and refer claims for DME and PMD services only.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 4 days ago.

Profile Details

Provider ID
1780989947
Provider Type
Individual
Full Name
Breese, William R
Credential
PA

Gender
Male
Sole Proprietor
No
Enumeration Date
1/20/2011
Last Updated
2/15/2021

Contact Information

Practice Location

35 Michigan NE, Suite 4150, Grand Rapids, MI 49503

(616) 267-2600

(616) 267-2601

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 5601005951 Michigan

Provider Identifiers

ID	Description	Issuer
ID 5601005951	Description Other	Issuer PA LICENSE Michigan

William R Breese

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Charles, Kara E

Schroeder, Adam Joseph

Rogers, Abby Jayne

Maatman, Caleb R

Lacourt, Ethan J

Bissonette, Gary

Jansma, Shannon M

Bremer, Sarah Ruth

Kuiper, Benjamin Daniel

Mccolley, Sarah