Individual provider Active NPI

Matthew Glenn Griffiths, PA-C

  • Physician Assistant
  • Grand Rapids, MI
National Provider Identifier
1124564133
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601008240 Issued in MI
Practice address
4100 Lake Dr SE Ste 300
Grand Rapids, MI 49546-8292
Phone
(616) 267-8860
NPI assigned
Jan 13, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2023

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 5601008240 MI Primary

Addresses

Primary practice location

4100 Lake Dr SE Ste 300
Grand Rapids, MI 49546-8292

Mailing address

100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20251006003888 TN Practitioner - Physician Assistant 9537444104 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Tennessee, HSC, College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crossroads Urgent Care PLLCGroup PAC ID 8325117484, 181 clinicians

Practice addresses (Care Compare)

2445 Memorial Blvd
Suite C
Murfreesboro, TN 37129-5156
Phone (615) 217-6900

524 Market Dr
Lenoir City, TN 37771-6463
Phone (865) 988-0096

6942 Maynardville Pike
Knoxville, TN 37918-5320
Phone (865) 292-6590

Merit-based Incentive Payment System (MIPS)

Final score
87.49 of 100Reported as group
Quality
78.04
Promoting interoperability
100
Improvement activities
40
Cost
75.09

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Allergy Specialists of Knoxville PLLC Past Accepting new patients
Tri-State Orthopaedic Surgeons, Inc. Physician Assistant Past Accepting new patients
Ella E M Brown Charitable Circle Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1484265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1124564133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 LAKE DR SE STE 300",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468292",
            "telephone_number": "616-267-8860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFITHS",
        "first_name": "MATTHEW",
        "middle_name": "GLENN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-13",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.