Individual provider Active NPI

Matthew Brandon Kanitz, P.A

  • Physician Assistant
  • Alma, MI
National Provider Identifier
1215305099
Registry record updated Sep 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601007517 Issued in MI
Practice address
300 E Warwick Dr
Alma, MI 48801-1014
Phone
(989) 466-3275
NPI assigned
Sep 9, 2015
Last updated
Sep 9, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2015

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 5601007517 MI Primary

Addresses

Primary practice location

300 E Warwick Dr
Alma, MI 48801-1014

Mailing address

715 Cobb St
Cadillac, MI 49601-2567

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
I20150929000952 MI Practitioner - Physician Assistant 4183932924 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sturgis Hospital IncGroup PAC ID 5395884621, 16 clinicians

Practice addresses (Care Compare)

916 Myrtle St
Sturgis, MI 49091-2326
Phone (269) 651-7824

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601007517MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Clare Physician Assistant CurrentSince Oct 24, 2023 Accepting new patients
Mymichigan Medical Center Clare CurrentSince Oct 24, 2023 Accepting new patients
Sturgis Hospital, Inc. Current Accepting new patients
Mymichigan Medical Center Alma CurrentSince Oct 24, 2023 Accepting new patients
West Branch Regional Medical Center Current Accepting new patients
Mymichigan Medical Center West Branch CurrentSince Oct 1, 2023 Accepting new patients
Mymichigan Medical Center Alma CurrentSince Oct 24, 2023 Accepting new patients
Sturgis Hospital, Inc. CurrentSince Oct 13, 2024 Accepting new patients
Mymichigan Medical Center West Branch CurrentSince Oct 1, 2023 Accepting new patients
Mymichigan Medical Center Alpena CurrentSince Oct 24, 2023 Accepting new patients
Mymichigan Medical Center Alpena CurrentSince Oct 24, 2023 Accepting new patients

Locations

300 E Warwick Dr
Alma, MI 48801
Phone (989) 463-0104

321 E Warwick Dr
Alma, MI 48801
Phone (989) 463-0957

1501 W Chisholm St
Alpena, MI 49707
Phone (989) 356-7000

703 N McEwan St
Clare, MI 48617
Phone (989) 802-5000

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

916 Myrtle St
Sturgis, MI 49091
Phone (269) 651-7824

916 Myrtle St
Ste 105
Sturgis, MI 49091

2463 S M 30
West Branch, MI 48661
Phone (517) 345-3660

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 3

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": "1441756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441756800000",
    "number": "1215305099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 COBB ST",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496012567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E WARWICK DR",
            "city": "ALMA",
            "state": "MI",
            "postal_code": "488011014",
            "telephone_number": "989-466-3275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANITZ",
        "first_name": "MATTHEW",
        "middle_name": "BRANDON",
        "credential": "P.A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-09",
        "last_updated": "2015-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alma, MI

Sources for this page

Verify at the official NPI Registry.