Active NPI
Matthew Paul Vasievich, M.D.
- Dermatology Physician
- Ann Arbor, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 4301111784
- Practice address
- 4200 Whitehall Dr Ste 250
Ann Arbor, MI 48105-9694 - Phone
- (734) 677-3376
- Fax
- (734) 572-3229
- NPI assigned
- Jun 2, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dermatology Physician | 207N00000X | 4301111784 | MI | Primary |
Addresses
Primary practice location
4200 Whitehall Dr Ste 250
Ann Arbor, MI 48105-9694
Mailing address
3810 Central Pike
Hermitage, TN 37076-3494
Phone (815) 744-8554
Other practice location 1
9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-2200
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Dermatology
- Education
- University of Michigan Medical School, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2433 Oak Valley Dr
Suite 400
Ann Arbor, MI 48103-7602
Phone (734) 477-0200
Hospital & facility affiliations
- University of Michigan Health System
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 15 |
| Removal of skin lesions | 870 |
| Removal or shaving of skin growth | 17 |
| Skin biopsy | 302 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301111784 | MI | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Audrey Bruell, M.D. P.C. | Dermatology | Current | Accepting new patients |
| Iha Health Services Corporation | Current | Accepting new patients | |
| Pinnacle Dermatology, SC | Current | Accepting new patients | |
| Iha Health Service Corporation | Current | Accepting new patients | |
| Iha Health Services Corporation | Current | Accepting new patients | |
| Iha Health Services Corporation | Past | Accepting new patients |
Locations
4200 Whitehall Dr
Ste 250
Ann Arbor, MI 48105
Phone (734) 622-5016
2305 Genoa Business Park Dr
Ste 200
Brighton, MI 48114
Phone (810) 494-6840
128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677
37605 Pembroke Ave
Livonia, MI 48152
Phone (734) 591-7931
44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700
3810 Central Pike
Hermitage, TN 37076
Interoperability endpoints
- mvasievich23810@direct.trinity-health.org
Organizations & group practices 7
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.
-
- Obstetrics & Gynecology Physician
- Canton, MI
- NPI 1457408965
-
- Dermatology Physician
- Livonia, MI
- NPI 1306965983
-
- Obstetrics & Gynecology Physician
- Ypsilanti, MI
- NPI 1831053701
-
- Plastic and Reconstructive Surgery Physician
- Brighton, MI
- NPI 1326679879
-
- Non-Pharmacy Dispensing Site
- Clarksville, TN
- NPI 1245901941
-
- Family Medicine Physician
- Milan, MI
- NPI 1467509067
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Ann Arbor, MI
- NPI 1003878539
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1370131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669075200000",
"number": "1235576174",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3810 CENTRAL PIKE",
"city": "HERMITAGE",
"state": "TN",
"postal_code": "370763494",
"telephone_number": "815-744-8554"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4200 WHITEHALL DR STE 250",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481059694",
"telephone_number": "734-677-3376",
"fax_number": "734-572-3229"
}
],
"practiceLocations": [
{
"address_1": "9500 Euclid Ave",
"address_purpose": "LOCATION",
"city": "Cleveland",
"state": "OH",
"postal_code": "441950001",
"country_code": "US",
"telephone_number": "216-444-2200",
"fax_number": "216-636-5830",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VASIEVICH",
"first_name": "MATTHEW",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-06-02",
"last_updated": "2022-11-22",
"certification_date": "2022-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "MI",
"license": "4301111784",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.