Individual provider Active NPI

Kathleen Grew, PA-C

  • Physician Assistant
  • Bay City, MI
National Provider Identifier
1235639626
Registry record updated Nov 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601008579 Issued in MI
Practice address
1900 Columbus Ave
Bay City, MI 48708-6831
Phone
(989) 894-3000
NPI assigned
Feb 13, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2022

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 5601008579 MI Primary

Addresses

Primary practice location

1900 Columbus Ave
Bay City, MI 48708-6831

Mailing address

4604 Autumn Ridge Cir N
Midland, MI 48642-6814
Phone (989) 415-2705

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
I20180723002185 MI Practitioner - Physician Assistant 2769739788 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren Bay RegionGroup PAC ID 5597659011, 110 clinicians

Practice addresses (Care Compare)

1900 Columbus Ave
Bay Regional
Bay City, MI 48708-6831
Phone (989) 894-3278

Hospital & facility affiliations

  • McLaren Bay Region Hospital, Bay City, MI, CCN 230041

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601008579MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Bay Region Physician Assistant CurrentSince Jul 30, 2018 Accepting new patients
McLaren Bay Region CurrentSince Jul 30, 2018 Accepting new patients
McLaren Bay Region Past Accepting new patients

Locations

1900 Columbus Ave
Bay City, MI 48708
Phone (989) 894-3000

1900 Columbus Ave
Fl 4
Bay City, MI 48708
Phone (231) 878-0361

2940 Health Pkwy
Mt Pleasant, MI 48858
Phone (989) 466-2877

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 1

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": "1518480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667347200000",
    "number": "1235639626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4604 AUTUMN RIDGE CIR N",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486426814",
            "telephone_number": "989-415-2705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 COLUMBUS AVE",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487086831",
            "telephone_number": "989-894-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREW",
        "first_name": "KATHLEEN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-13",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay City, MI

Sources for this page

Verify at the official NPI Registry.