Christopher Cantu, PA-C
Individual provider Active NPI Physician Assistant · Grand Rapids, MI
NPI 1124685193 · NPPES record last updated Jun 26, 2023
Key facts
- NPI
- 1124685193
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 5601009443 (MI)
- Practice address
- 100 Michigan St NE Ste 4297
Grand Rapids, MI 49503-2560 - Phone
- (616) 267-7900
- NPI assigned
- May 24, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Intermountain Medical Group Grand Junction, LLC
Practice addresses (Care Compare)
1050 Wellington Ave
Imh Wellington Lung and Sleep Clinic
Grand Junction, CO 81501-8121
Phone (970) 298-5864
Hospital & facility affiliations
- Intermountain Health St. Mary'S Regional Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230718001838 | CO | Practitioner - Physician Assistant | 1153656665 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Intermountain Medical Group Grand Junction, LLC | Current |
Accepting new patients | |
| Intermountain Medical Group Grand Junction, LLC | Current |
Accepting new patients | |
| St Mary'S Hospital and Medical Center, Inc | Past | Accepting new patients |
Locations
1050 Wellington Ave
Slp Ctr
Grand Junction, CO 81501
Phone (970) 298-5864
1050 Wellington Ave
Grand Junction, CO 81501
Phone (970) 245-4810
750 Wellington Ave
Ste 3C
Grand Junction, CO 81501
Phone (970) 243-7908
Interoperability endpoints
- ccantu520769@direct.hfhs.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601009443 | MI | Yes |
Addresses
Primary practice location
100 Michigan St NE Ste 4297
Grand Rapids, MI 49503-2560
Mailing address
100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560
NPI Registry JSON
{
"created_epoch": "1558656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687737600000",
"number": "1124685193",
"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": "100 MICHIGAN ST NE STE 4297",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495032560",
"telephone_number": "616-267-7900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANTU",
"first_name": "CHRISTOPHER",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-05-24",
"last_updated": "2023-06-26",
"certification_date": "2023-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601009443",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
- John Paul Cantor
- Jordan Cantor
- Anna Maria Cantu
- Austin Cantu
- Cade Cantu
- Lani S Cantu
- Hanna Canute
- Hannah M Canute
- Connie Du Cao
- Eric M Cao
All providers in Grand Rapids, MI · Physician Assistant in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 26, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.