Individual provider Active NPI

Matthew Dale Myaard, PA-C

  • Physician Assistant
  • Holland, MI
National Provider Identifier
1255797643
Registry record updated Apr 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601007659 Issued in MI
Practice address
370 N. 120TH Ave
Holland, MI 49424-2196
Phone
(616) 396-5855
Fax
(616) 396-5720
NPI assigned
Jan 14, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2017

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 5601007659 MI Primary

Addresses

Primary practice location

370 N. 120TH Ave
Holland, MI 49424-2196

Mailing address

370 N 120TH Ave
Holland, MI 49424-2196
Phone (616) 396-5855

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
I20160210001322 MI Practitioner - Physician Assistant 0840594925 Reassigns benefits to 3 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
Orthopaedic Associates of Muskegon PCGroup PAC ID 7214908045, 113 clinicians
Shoreline Orthopaedic and Sports Medicine Clinic P L CGroup PAC ID 6002891926, 25 clinicians

Practice addresses (Care Compare)

1400 Mercy Dr
Suite 100
Muskegon, MI 49444-1833
Phone (231) 733-1326

370 N 120TH Ave
Holland, MI 49424-2196

Hospital & facility affiliations

  • Holland Hospital Hospital, Holland, MI, CCN 230072
  • Bronson South Haven Hospital Hospital, South Haven, MI, CCN 230085

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Shoreline Orthopaedic & Sports Medicine Clinic P L C CurrentSince Aug 7, 2023 Accepting new patients
Advantage Health Saint Mary'S Medical Group Physician Assistant CurrentSince Mar 4, 2016 Accepting new patients
Advantage Health/Saint Mary'S Medical Group CurrentSince Mar 4, 2016 Accepting new patients

Locations

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

370 N 120th Ave
Ste 20
Holland, MI 49424
Phone (616) 396-5855

370 N 120th Ave
Holland, MI 49424
Phone (616) 396-5855

8251 Westpark Way
Zeeland, MI 49464
Phone (616) 355-3930

Organizations & group practices 6

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 2

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": "1452729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493251200000",
    "number": "1255797643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 N 120TH AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494242196",
            "telephone_number": "616-396-5855",
            "fax_number": "616-396-5720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 N. 120TH AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494242196",
            "telephone_number": "616-396-5855",
            "fax_number": "616-396-5720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYAARD",
        "first_name": "MATTHEW",
        "middle_name": "DALE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-14",
        "last_updated": "2017-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

Verify at the official NPI Registry.