Marina Matta, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

17108 Mack Ave Ste 108
Grosse Pointe Farms, MI 48230-6224

Phone

(313) 723-2572

NPI assigned

Oct 9, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Shelby Urgent Care PC

  • Urgent Care Clinic/Center
  • Shelby TWP, MI
  • NPI 1326320599
  Medicare reassignment NPD
• Elizabeth Lake Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Waterford, MI
  • NPI 1538585260
  Medicare reassignment
• Harper Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Saint Clair Shores, MI
  • NPI 1992442560
  Medicare reassignment
• Lakeside Urgent Care, P. C.

  • Urgent Care Clinic/Center
  • Clinton Township, MI
  • NPI 1720159304
  Medicare reassignment
• Mound Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Warren, MI
  • NPI 1063159630
  Medicare reassignment
• Oxford Urgent Care P L C

  • Specialist
  • Oxford, MI
  • NPI 1700036936
  Medicare reassignment
• Romeo Plank Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Macomb, MI
  • NPI 1184385791
  Medicare reassignment
• Royal Urgent Care, PLLC

  • Internal Medicine Physician
  • Royal Oak, MI
  • NPI 1952833196
  Medicare reassignment
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  MI

  Medicare reassignment
• Lakeside Urgent Care, P.C.

  • Internal Medicine Physician
  • Clinton Township, MI
  • NPI 1811226442
  NPD
• Rochester Urgent Care, P. C.

  • Family Medicine Physician
  • Rochester Hills, MI
  • NPI 1235377052
  NPD
• Somerset Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Troy, MI
  • NPI 1679916258
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1570579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771286400000",
    "number": "1053953273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17108 MACK AVE STE 108",
            "city": "GROSSE POINTE FARMS",
            "state": "MI",
            "postal_code": "482306224",
            "telephone_number": "313-723-2572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17108 MACK AVE STE 108",
            "city": "GROSSE POINTE FARMS",
            "state": "MI",
            "postal_code": "482306224",
            "telephone_number": "313-723-2572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTA",
        "first_name": "MARINA",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-09",
        "last_updated": "2026-02-17",
        "certification_date": "2026-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott C Loranger
• Ruth D Mannschreck, DDS
• Maridel Hernandez Internal Medicine PC
• Lea Ann Martinico, LMSW
• Karen Andrea Matron, PA
• Kathleen Anne McAvoy, M.A.
• Megan McCarren, LLMSW
• Erin Marie McCarthy, FNP-BC
• Melissa McCarthy
• Diane McCormack, PH.D.

• Physician Assistant in Grosse Pointe Farms, MI
• Providers in Grosse Pointe Farms, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.