Graceson Caroline Maxa

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601010272 Issued in MI

Practice address

4000 Wellness Dr
Midland, MI 48670-2000

Phone

(989) 794-5240

NPI assigned

Oct 28, 2020

Last updated

Jun 7, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Edward W Sparrow Hospital AssociationGroup PAC ID 6709799166, 698 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Edward W Sparrow Hospital Hospital, Lansing, MI, CCN 230230

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gmaxa103442@mymichiganhealth.midirect.net

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.

• Edward W. Sparrow Hospital Association

  dba Sparrow Regional Children's Center

  • Pediatrics Physician
  • Lansing, MI
  • NPI 1831139088
  Medicare reassignment Care Compare group
• Edward W Sparrow Hospital Association

  dba University of Michigan Health-Sparrow

  • Adult Health Nurse Practitioner
  • Lansing, MI
  • NPI 1265220438
  NPD
• Edward W. Sparrow Hospital Association

  dba SMG Infectious Disease

  • Infectious Disease Physician
  • Lansing, MI
  • NPI 1508438995
  NPD
• Edward W. Sparrow Hospital Association

  dba Sparrow Cardiovascular & Thoracic Surgeons

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Lansing, MI
  • NPI 1033162326
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Edward W Sparrow Hospital Association

  dba University of Michigan Health-Sparrow Lansing

  • General Acute Care Hospital
  • Lansing, MI
  • NPI 1073588711
  Care Compare affiliation
• Edward W Sparrow Hospital Association

  dba Thoracic Cardiovascular Institute

  • General Acute Care Hospital
  • Lansing, MI
  • NPI 1760710719
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1603843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1396345575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 WELLNESS DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486700001",
            "telephone_number": "989-832-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 WELLNESS DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486702000",
            "telephone_number": "989-794-5240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXA",
        "first_name": "GRACESON",
        "middle_name": "CAROLINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-28",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601010272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Matt
• Stephen J Mattichak, MD
• Brehanna Elaine Matzke
• Kayla Matzke
• Brian Mauch, MD
• Jennifer Christine Maxam Fenner, D.O.
• Cilisa Maxson
• Maxwell Hogue DDS PLC
• Megan Maxwell, NCHW-C
• Melissa Kathryn Maxwell, LMSW

• Physician Assistant in Midland, MI
• Providers in Midland, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 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.

Verify at the official NPI Registry.