Physician Compare National (NPI:1356448054)

HEALTHCARE PROVIDER: MELINDA S TRIEMSTRA LCSW

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1356448054
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8325286677
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20130529000293
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	TRIEMSTRA
	Individual professional last name
Provider First Name	MELINDA
	Individual professional first name
Provider Middle Name	S
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1985
	Individual professional's medical school graduation year
Primary Specialty	CLINICAL SOCIAL WORKER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	ASCENSION BORGESS LEE HOSPITAL
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	7719881002
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	27
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	420 W HIGH ST
	Group Practice or individual's line 1 address
Marker of address line 2 suppression	Y
	Marker that address as reported may be incomplete
City	DOWAGIAC
	Group Practice or individual's city
State	MI
	Group Practice or individual's state
Zip Code	490471943
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y