Individual provider Active NPI

Matthew Brower

  • Physician Assistant
  • Wyoming, MI
National Provider Identifier
1205174604
Registry record updated Feb 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601006586 Issued in MI
Practice address
6105 Wilson Ave SW
Suite 101
Wyoming, MI 49418-9714
Phone
(616) 608-8300
Fax
(616) 608-8301
NPI assigned
Jan 21, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2021

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 5601006586 MI Primary

Addresses

Primary practice location

6105 Wilson Ave SW
Suite 101
Wyoming, MI 49418-9714

Mailing address

100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mbrower56932@epic00.shdirect.org
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20130311000373 MI Practitioner - Physician Assistant 2668627050 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spectrum Health Primary Care PartnersGroup PAC ID 4587568647, 2,283 clinicians

Practice addresses (Care Compare)

100 Michigan Ave NE
Grand Rapids, MI 49503-2560

100 Michigan St NE RM
280 Corewell Health Medical Group West
Grand Rapids, MI 49503-2560
Phone (616) 267-0115

3152 Port Sheldon St
Hudsonville, MI 49426-9297
Phone (616) 494-5830

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

6105 Wilson Ave SW
Wyoming, MI 49418-9714

6105 Wilson Ave SW FL
2 Corewell Health Medical Group West
Wyoming, MI 49418-9714
Phone (616) 267-8950

615 S Bower St
Greenville, MI 48838-2614
Phone (616) 225-6522

Hospital & facility affiliations

  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038
  • Spectrum Health United Hospital Hospital, Greenville, MI, CCN 230035
  • Corewell Health Zeeland Hospital Hospital, Zeeland, MI, CCN 230003

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601006586MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners CurrentSince Feb 16, 2015 Accepting new patients
Spectrum Health Primary Care Partners Current Accepting new patients

Locations

2900 Bradford St NE
Grand Rapids, MI 49525

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

6105 Wilson Ave SW
Ste 101
Wyoming, MI 49418
Phone (616) 608-8300

Interoperability endpoints

  • Direct secure messaging: mbrower56932@epic00.corewelldirect.org
  • Direct secure messaging: mbrower56932@epic00.shdirect.org

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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": "1358726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613433600000",
    "number": "1205174604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC 845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6105 WILSON AVE SW",
            "address_2": "SUITE 101",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "494189714",
            "telephone_number": "616-608-8300",
            "fax_number": "616-608-8301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWER",
        "first_name": "MATTHEW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-21",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601006586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbrower56932@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "6105 Wilson Ave SW",
            "address_2": "Suite 101",
            "city": "Wyoming",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494189714",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "6105 Wilson Ave SW",
            "address_2": "Suite 101",
            "city": "Wyoming",
            "state": "MI",
            "country_code": "US",
            "postal_code": "494189714",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

Verify at the official NPI Registry.