Mitchell John Fogal, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601011747 Issued in MI

Practice address

370 N 120TH Ave Ste 20
Holland, MI 49424-2196

Phone

(616) 396-5855

Fax

(877) 592-0688

NPI assigned

Jul 15, 2012

Sex

Male

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 SC, MI2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2012

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)

Hospital & facility affiliations

• Holland Hospital Hospital, Holland, MI, CCN 230072

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Orthopaedic Associates of Muskegon, PC

  • Orthopaedic Surgery Physician
  • Muskegon, MI
  • NPI 1972566594
  Medicare reassignment Care Compare group NPD
• Shoreline Orthopaedic & Sports Medicine Clinic,PLC

  • Orthopaedic Surgery Physician
  • Holland, MI
  • NPI 1275579765
  Medicare reassignment Care Compare group
• Gavin Orthopaedics

  • Orthopaedic Surgery Physician
  • Hilton Head, SC
  • NPI 1598955726
  Medicare reassignment
• Orthopaedic Associates of Muskegon, PC

  • Orthopaedic Surgery Physician
  • Grand Haven, MI
  • NPI 1215650221
  NPD
• Shoreline Orthopaedic & Sports Medicine Clinic P L C

  • Durable Medical Equipment & Medical Supplies
  • Zeeland, MI
  • NPI 1881370799
  NPD
• Gavin Orthopaedics

  • Orthopaedic Surgery Physician
  • Ridgeland, SC
  • NPI 1952887523
  NPD
• Infinite Health Collaborative, PA

  • Durable Medical Equipment & Medical Supplies
  • River Falls, WI
  • NPI 1144608589
  NPD (past)

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

• Holland Community Hospital

  • General Acute Care Hospital
  • Holland, MI
  • NPI 1871672618
  Care Compare affiliation

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

{
    "created_epoch": "1342310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1407101538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 N 120TH AVE STE 20",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494242196",
            "telephone_number": "616-396-5855",
            "fax_number": "877-592-0688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 N 120TH AVE STE 20",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494242196",
            "telephone_number": "616-396-5855",
            "fax_number": "877-592-0688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOGAL",
        "first_name": "MITCHELL",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-15",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601011747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bruce Michael Fletter, MD
• Florecer Doula Services, LLC
• Cassandra Flores-Calderon
• Dyjana Flourry-Moore
• Edward P. Fody, M.D.
• Fogg Chiropractic
• Adam Michael Fogg, D.C.
• Maria S Fogle
• Mark Norval Folkening, MD
• Foot & Ankle Specialists of West Michigan P L L C

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2025; 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.