NPIMap

Individual provider Active NPI

Matthew John Moser, PA-C

  • Physician Assistant
  • Muskegon, MI
National Provider Identifier
1093200081
Registry record updated Jun 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601008707 Issued in MI
Practice address
1500 E Sherman Blvd
Muskegon, MI 49444-1849
Phone
(231) 672-3883
NPI assigned
Jun 22, 2018
Last updated
Jun 22, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601008707 MI Primary

Addresses

Primary practice location

1500 E Sherman Blvd
Muskegon, MI 49444-1849

Mailing address

112 Chicory St NE
Comstock Park, MI 49321-8233
Phone (616) 706-3196

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180806002565 MI Practitioner - Physician Assistant 5496003568 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Wayne State University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Westshore Cardiology ServicesGroup PAC ID 5991932360, 36 clinicians
Mercy Specialty ServicesGroup PAC ID 2365439544, 87 clinicians

Practice addresses (Care Compare)

1212 E Sherman Blvd
Muskegon, MI 49444-1879
Phone (231) 672-3500

1500 E Sherman Blvd
Muskegon, MI 49444-1849
Phone (231) 672-3883

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Health Saint Mary's Medical Group Physician Assistant CurrentSince Mar 1, 2024 Accepting new patients
Mercy Health Partners CurrentSince Aug 1, 2018 Accepting new patients
Advantage Health/Saint Mary's Medical Group CurrentSince Mar 1, 2024 Accepting new patients
Mercy Physician Network Physician Assistant CurrentSince Aug 1, 2018 Accepting new patients
Mercy Health Partners CurrentSince Aug 1, 2018 Accepting new patients

Locations

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

1150 E Sherman Blvd
Muskegon, MI 49444
Phone (231) 672-6740

1212 E Sherman Blvd
Muskegon, MI 49444
Phone (231) 672-3500

1277 Mercy Dr
Slp Ctr
Muskegon, MI 49444
Phone (231) 672-6186

1500 E Sherman Blvd
Muskegon, MI 49444
Phone (231) 672-3027

71 Bevier St
Shelby, MI 49455
Phone (231) 861-2172

Interoperability endpoints

  • Direct secure messaging: mmoser36834@direct.trinity-health.org

Organizations & group practices 11

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1529625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529625600000",
    "number": "1093200081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 CHICORY ST NE",
            "city": "COMSTOCK PARK",
            "state": "MI",
            "postal_code": "493218233",
            "telephone_number": "616-706-3196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E SHERMAN BLVD",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441849",
            "telephone_number": "231-672-3883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSER",
        "first_name": "MATTHEW",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-22",
        "last_updated": "2018-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

Verify at the official NPI Registry.