JUSTINE MELODIE OUDSEMA PA-C
NPI 1003365396
Physician Assistant in Kalamazoo, MI
Quality Rating: 88.79 out of 100 score
NPI Status: Active since September 27, 2016
Contact Information
601 JOHN ST
BOX 74
KALAMAZOO, MI
ZIP 49007
Phone: (269) 341-8481
Fax: (269) 341-7781
- Individual
- Female
- Physician Assistant
- Accepts Insurance
- PECOS Enrolled
About JUSTINE OUDSEMA
This page provides the complete NPI Profile along with additional information for Justine Oudsema, a primary care provider established in Kalamazoo, Michigan with a medical specialization in Physician Assistant. The healthcare provider is registered in the NPI registry with number 1003365396 assigned on September 2016. The practitioner's primary taxonomy code is 363A00000X with license number 5601007970 (MI). The provider is registered as an individual and her NPI record was last updated one year ago.
- NPI
- 1003365396
- Provider Name
- JUSTINE MELODIE OUDSEMA PA-C
- Other Name
- JUSTINE MELODIE BENJAMIN PA-C
- Other Name Type
- Former Name (1)
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 601 JOHN ST BOX 74 KALAMAZOO, MI 49007
- Location Phone
- (269) 341-8481
- Location Fax
- (269) 341-7781
- Mailing Address
- 601 JOHN ST BOX 74 KALAMAZOO, MI 49007
- Mailing Phone
- (269) 341-8481
- Mailing Fax
- (269) 341-7781
- Is Sole Proprietor?
- No
- Enumeration Date
- 09-27-2016
- Last Update Date
- 04-25-2024
- Code Navigator
A primary care provider (PCP) like Justine Oudsema sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Physician Assistant
- Taxonomy Code
- 363A00000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- 5601007970
- License State
- MI
- Taxonomy Description
- 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.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Cross� Preferred HMO Bronze Extra - HMO
- Blue Cross� Preferred HMO Bronze Saver HSA - HMO
- Blue Cross� Preferred HMO Bronze Secure - HMO
- Blue Cross� Preferred HMO Gold - HMO
- Blue Cross� Preferred HMO Gold Extra - HMO
- Blue Cross� Preferred HMO Silver - HMO
- Blue Cross� Preferred HMO Silver Extra - HMO
- Blue Cross� Preferred HMO Silver Saver - HMO
- Blue Cross� Preferred HMO Value - HMO
- Blue Cross� Select HMO Bronze Extra - HMO
- Blue Cross� Select HMO Bronze Saver HSA - HMO
- Blue Cross� Select HMO Bronze Secure - HMO
- Blue Cross� Select HMO Silver - HMO
- Blue Cross� Select HMO Silver Extra - HMO
- Blue Cross� Select HMO Silver Saver - HMO
- Blue Cross� Select HMO Value - HMO
- Blue Cross� Premier PPO Bronze Extra - PPO
- Blue Cross� Premier PPO Bronze HSA - PPO
- Blue Cross� Premier PPO Bronze Secure - PPO
- Blue Cross� Premier PPO Gold - PPO
- Blue Cross� Premier PPO Gold Extra - PPO
- Blue Cross� Premier PPO Silver - PPO
- Blue Cross� Premier PPO Silver Extra - PPO
- Blue Cross� Premier PPO Silver Saver HSA - PPO
- Blue Cross� Premier PPO Value - PPO
- MyPriority Balanced Silver - HMO
- MyPriority Balanced Silver Bronson Healthcare Partners - HMO
- MyPriority Balanced Silver Corewell Health West Michigan Network - HMO
- MyPriority Balanced Silver Corewell Health West Michigan Network (Allegan, Barry) - HMO
- MyPriority Enhanced Gold Bronson Healthcare Partners - HMO
- MyPriority Enhanced Gold Corewell Health West Michigan Network - HMO
- MyPriority Enhanced Gold Corewell Health West Michigan Network (Allegan, Barry) - HMO
- MyPriority Premier Silver - HMO
- MyPriority Premier Silver Bronson Healthcare Partners - HMO
- MyPriority Premier Silver Corewell Health West Michigan Network - HMO
- MyPriority Premier Silver Corewell Health West Michigan Network (Allegan, Barry) - HMO
- MyPriority Standard Bronze - HMO
- MyPriority Standard Bronze - Bronson Healthcare Partners - HMO
- MyPriority Standard Bronze - Corewell Health West Michigan Network - HMO
- MyPriority Standard Bronze - Corewell Health West Michigan Network (Allegan, Barry) - HMO
- MyPriority Standard Bronze - Travel - HMO
- MyPriority Standard Gold - HMO
- MyPriority Standard Gold Bronson Healthcare Partners - HMO
- MyPriority Standard Gold Corewell Health West Michigan Network - HMO
- MyPriority Standard Gold Corewell Health West Michigan Network (Allegan, Barry) - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Justine Oudsema is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Provider Referred Orders for Durable Medical Equipment, Devices & Supplies
The following list reflects the services, supplies or durable medical equipment ordered by this provider to a DME supplier on behalf of patients. The information below is derived from Medicare claims data and reflects the BETOS category, HCPCS code information and the number times each service was submitted under the Medicare fee-for-service program.
Durable Medical Equipment
DME-Oxygen and Supplies (DC000N)
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing (HCPCS:E0431)
1 DME suppliers used 11 Medicare Claims 11 Services Paid
DME-Other DME (DE000N)
Nebulizer, with compressor (HCPCS:E0570)
1 DME suppliers used 11 Medicare Claims 11 Services Paid
DME-Oxygen and Supplies (DC002N)
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate (HCPCS:E1390)
1 DME suppliers used 11 Medicare Claims 11 Services Paid
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Follow-up hospital inpatient care per day, typically 35 minutes
Follow-up nursing facility visit per day, typically 10 minutes
Follow-up nursing facility visit per day, typically 25 minutes
Hospital discharge day management, more than 30 minutes
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
This service was performed 59 times for 30 patientsA follow-up nursing facility visit per day typically lasts about 10 minutes. This service involves a healthcare professional checking on your health status, answering any questions you may have, and monitoring your progress. This routine check ensures your recovery is on track and any concerns are addressed promptly.
This service was performed 14 times for 14 patientsA follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
This service was performed 13 times for 12 patientsHospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
This service was performed 12 times for 12 patientsPhysician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 49007 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $84.74
- Minimum New Patient Price $54.34
- Maximum New Patient Price $166.68
- Average New Patient Copayment $21.18
- Minimum New Patient Copayment $13.58
- Maximum New Patient Copayment $41.67
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $68.07
- Minimum Established Patient Price $17.09
- Maximum Established Patient Price $135.4
- Average Established Patient Copayment $17.01
- Minimum Established Patient Copayment $4.27
- Maximum Established Patient Copayment $33.85
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Overall MIPS Quality Performance
The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 88.79, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.
The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.
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Final Score: 88.79 out of 100
The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.
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Quality Score: 85.85
The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.
There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
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Promoting Interoperability Score: 100
The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.
The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data. -
Improvement Activities Score: 40
The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.
The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores. -
Cost Score: 76.79
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores. -
Cost Score: 76.79
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 0 | 0 | 3 | 3 | 6 | 5 | 3 | 9 | 6 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 0 | 3 | 6 | 6 | 10 | 3 | 18 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 0 + 3 + 6 + 6 + 1 + 0 + 3 + 1 + 8 + 24 = 54 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 54 = 6 | 6 | ||||||||
The NPI number 1003365396 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1881689123 | DR. MARIJO SNYDER M.D. Individual | Obstetrics & Gynecology | 601 JOHN ST SUITE M318 KALAMAZOO, MI 49007 (269) 345-6197 |
| 1366437303 | MRS. SUSAN FULLER RNC WHNP Individual | Nurse Practitioner (Women's Health) | 601 JOHN ST SUITE M318 KALAMAZOO, MI 49007 (269) 345-6197 |
| 1780665257 | TOM GARLING M.D. Individual | Obstetrics & Gynecology | 601 JOHN ST SUITE N-1100 KALAMAZOO, MI 49007 (269) 343-4609 |
| 1497736755 | GREGORY FELDMEIER M.D. Individual | Obstetrics & Gynecology | 601 JOHN ST SUITE N-1100 KALAMAZOO, MI 49007 (269) 343-4609 |
| 1275516163 | DR. NIGEL H. BRAMWELL M.D. Individual | Pathology (Anatomic Pathology & Clinical Pathology) | 601 JOHN ST KALAMAZOO, MI 49007 (269) 341-7654 |
| 1275516908 | DR. WILLIAM T LEEBURG M.D. Individual | Pathology (Anatomic Pathology & Clinical Pathology) | 601 JOHN ST KALAMAZOO, MI 49007 (269) 341-7654 |
| 1629053368 | DR. RONALD JAMES ZEGERIUS MD Individual | Internal Medicine (Cardiovascular Disease) | 601 JOHN ST SUITE M230 KALAMAZOO, MI 49007 (269) 345-9606 |
| 1366428864 | DR. DAVID WILLIAM BURKE MD Individual | Internal Medicine (Cardiovascular Disease) | 601 JOHN ST SUITE M230 KALAMAZOO, MI 49007 (269) 345-9606 |
| 1235115734 | DR. BENJAMIN ALLAN PERRY MD Individual | Internal Medicine (Cardiovascular Disease) | 601 JOHN ST SUITE M230 KALAMAZOO, MI 49007 (269) 345-9606 |
| 1659358661 | MARK S MCCORMICK M.D. Individual | Internal Medicine (Gastroenterology) | 601 JOHN ST M 475 KALAMAZOO, MI 49007 (269) 276-0000 |
| 1417935149 | MS. JACQUELYN D RILEY M.S., C.G.C. Individual | Genetic Counselor, MS | 601 JOHN ST SUITE M-302 KALAMAZOO, MI 49007 (269) 341-6885 |
| 1518947191 | CAROL A HITE CNM Individual | Advanced Practice Midwife | 601 JOHN ST SUITE N1200 - BRONSON WOMEN'S SERVICES KALAMAZOO, MI 49007 (269) 341-7979 |
| 1992785505 | PENNY L WALTMAN CNM Individual | Advanced Practice Midwife | 601 JOHN ST STE M351, BRONSON WOMENS SERVICES KALAMAZOO, MI 49007 (269) 341-7979 |
| 1558341149 | GAIL L LENNAN CNM Individual | Advanced Practice Midwife | 601 JOHN ST SUITE N1200 BRONSON WOMEN'S SERVICES KALAMAZOO, MI 49007 (269) 341-7979 |
| 1699755033 | RAGHU RAJ SINGH MD Individual | Neurological Surgery | 601 JOHN ST SUITE M124 KALAMAZOO, MI 49007 (269) 341-7500 |
| 1952371411 | JAMES W CARTER MD Individual | Internal Medicine | 601 JOHN ST SUITE M020 KALAMAZOO, MI 49007 (269) 341-8400 |
| 1790755346 | J PATRICK LAVERY MD Individual | Pediatrics (Neonatal-Perinatal Medicine) | 601 JOHN ST STE M302 KALAMAZOO, MI 49007 (269) 341-7887 |
| 1285604751 | PAUL A BLOSTEIN MD Individual | Surgery (Trauma Surgery) | 601 JOHN ST SUITE M351 KALAMAZOO, MI 49007 (269) 341-6022 |
| 1689648446 | MR. DAVID D SHORT R.PH., MBA Individual | Pharmacist | 601 JOHN ST KALAMAZOO, MI 49007 (269) 341-7999 |
| 1659349637 | KATHY BROCKWAY RD Individual | Dietitian, Registered | 601 JOHN ST KALAMAZOO, MI 49007 (269) 341-8585 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1003365396, enumerated in the NPI registry as an "individual" on September 27, 2016
The provider is located at 601 John St Box 74 Kalamazoo, Mi 49007 and the phone number is (269) 341-8481
The provider's speciality is Physician Assistant with taxonomy code 363A00000X
The provider might be accepting Accepts: Blue Care Network of Michigan, Blue Cross Blue. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
The provider has an overall high rating in the following quality measures: quality clinical practices and patient outcomes and experiences , uses technology to exchange and make use of healthcare information.
Medicare beneficiaries should expect a typical cost of $84.74 with an average copayment of $21.18 for new patient appointments. Established patients should expect a typical charge of $68.07 and an average copayment of 17.01. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: Follow-up hospital inpatient care per day, typically 35 minutes, Follow-up nursing facility visit per day, typically 10 minutes, Follow-up nursing facility visit per day, typically 25 minutes and Hospital discharge day management, more than 30 minutes.
This NPI record was last updated on September 27, 2016. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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