Kaylee Diekevers, PA-C
Dermatology in Grand Rapids, MI. Individual provider (NPI-1).
NPI number1346938115
StatusActive
Last updated in NPPESJun 22, 2026
Details
- NPI
- 1346938115
- Entity type
- Individual (NPI-1)
- Name
- Kaylee Diekevers
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 28, 2023
- Certification date
- Jun 22, 2026
- Last updated
- Jun 22, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207N00000X | Dermatology | 5601012583 | MI | Yes |
Practice location
1000 E Paris Ave Se Ste 104Grand Rapids, MI 49546-3680
Phone 616-369-1600 · Fax 616-328-6189
Mailing address
43151 Dalcoma Dr Ste 4Clinton Township, MI 48038-6306
Phone 586-286-8720 · Fax 866-790-6803
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