NPIMap

Individual provider Active NPI

Alissa Marie Matthews, P.A.

  • Physician Assistant
  • Cedar Springs, MI
National Provider Identifier
1265451884
Registry record updated Nov 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601002704 Issued in MI
Practice address
261 N. Main Street
Cedar Springs,, MI 49319
Phone
(616) 696-2020
Fax
(616) 696-4860
NPI assigned
Jul 18, 2006
Last updated
Nov 29, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2007

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 5601002704 MI Primary

Addresses

Primary practice location

261 N. Main Street
Cedar Springs,, MI 49319

Mailing address

261 N. Main Street
Cedar Springs,, MI 49319
Phone (616) 696-2020

Other identifiers 2

IdentifierTypeStateIssuer
1018850OtherMIMCCLAREN HEALTH PLAN
P00307608OtherMIMETRA UNITED HEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041122000478 MI Practitioner - Physician Assistant 7214992064 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
White Pine Family Medicine PLLCGroup PAC ID 4082653423, 9 clinicians

Practice addresses (Care Compare)

261 N Main
Cedar Springs, MI 49319-8041
Phone (616) 696-2020

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
White Pine Family Medicine Physician Assistant Current Accepting new patients
Ambulatory United Past Accepting new patients
Ambulatory United Physician Assistant Past Accepting new patients
West Michigan Heart Physician Assistant Past Accepting new patients

Locations

261 N Main St
Cedar Springs, MI 49319
Phone (616) 287-5637

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HGAFAA

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
White Pine Family Medicine PLLCCedar Springs, MI, CCN 233808 Rural health clinic 5% Or Greater Direct Ownership Interest (50%)
Operational/Managerial Control		 Apr 1, 2005
Apr 1, 2005

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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.

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196294400000",
    "number": "1265451884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 N. MAIN STREET",
            "city": "CEDAR SPRINGS,",
            "state": "MI",
            "postal_code": "49319",
            "telephone_number": "616-696-2020",
            "fax_number": "616-696-4860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 N. MAIN STREET",
            "city": "CEDAR SPRINGS,",
            "state": "MI",
            "postal_code": "49319",
            "telephone_number": "616-696-2020",
            "fax_number": "616-696-4860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTHEWS",
        "first_name": "ALISSA",
        "middle_name": "MARIE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601002704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCCLAREN HEALTH PLAN",
            "identifier": "1018850",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "METRA UNITED HEALTH",
            "identifier": "P00307608",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Springs, MI

Sources for this page

Verify at the official NPI Registry.