Individual provider Active NPI

Matthew T Zoeteman, PA-C

  • Physician Assistant
  • Grand Rapids, MI
National Provider Identifier
1356844831
Registry record updated Jul 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601008558 Issued in MI
Practice address
833 Michigan St NE
Suite 102
Grand Rapids, MI 49503-3523
Phone
(616) 459-8209
Fax
(616) 459-0313
NPI assigned
Mar 12, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2025

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 5601008558 MI Primary

Addresses

Primary practice location

833 Michigan St NE
Suite 102
Grand Rapids, MI 49503-3523

Mailing address

833 Michigan St NE
Suite 102
Grand Rapids, MI 49503-3523
Phone (616) 459-8209

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
I20180321000400 MI Practitioner - Physician Assistant 1951663426 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
H2 Dermatology PLLCGroup PAC ID 9739510348, 13 clinicians

Practice addresses (Care Compare)

5120 Midland Rd
Saginaw, MI 48603-9601
Phone (989) 401-1463

6225 Jefferson Ave
Midland, MI 48640-3900
Phone (989) 401-1463

833 Michigan St NE
Suite 102a
Grand Rapids, MI 49503-2578
Phone (616) 459-8209

Hospital & facility affiliations

  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038
  • Mercy Health Saint Mary'S Hospital, Grand Rapids, MI, CCN 230059

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Center of Grand Rapids PC Current Accepting new patients

Locations

597 Baldwin St
Jenison, MI 49428
Phone (616) 457-0760

Organizations & group practices 2

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 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": "1520812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752710400000",
    "number": "1356844831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 MICHIGAN ST NE",
            "address_2": "SUITE 102",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495033523",
            "telephone_number": "616-459-8209",
            "fax_number": "616-459-0313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 MICHIGAN ST NE",
            "address_2": "SUITE 102",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495033523",
            "telephone_number": "616-459-8209",
            "fax_number": "616-459-0313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZOETEMAN",
        "first_name": "MATTHEW",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-12",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.