Individual provider Active NPI

Marcia A Fitzgerald, PA-C

  • Physician Assistant
  • Grand Rapids, MI
National Provider Identifier
1467577817
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601002935 Issued in MI
Practice address
414 Plymouth Ave NE
Grand Rapids, MI 49505-6038
Phone
(616) 454-3465
Fax
(616) 454-9004
NPI assigned
Mar 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 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 5601002935 MI Primary

Addresses

Primary practice location

414 Plymouth Ave NE
Grand Rapids, MI 49505-6038

Mailing address

414 Plymouth Ave NE
Grand Rapids, MI 49505-6038
Phone (616) 454-3465

Other names 1

  • Marcia F Nauta Former name

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
I20070531000427 MI Practitioner - Physician Assistant 3971601832 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Great Lakes Neurosurgical Associates PCGroup PAC ID 5890691182, 13 clinicians

Practice addresses (Care Compare)

3350 Eagle Park Dr NE
Suite 102
Grand Rapids, MI 49525-4570
Phone (616) 454-3465

Hospital & facility affiliations

  • University of Michigan Health - West Hospital, Wyoming, MI, CCN 230236
  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038
  • Corewell Health Big Rapids Hospital Hospital, Big Rapids, MI, CCN 230093

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sheridan Community Hospital CurrentSince May 1, 2024 Accepting new patients
Sheridan Community Hospital CurrentSince May 1, 2024 Accepting new patients
Great Lakes Neurosurgical Associates, PC CurrentSince Mar 11, 2025 Accepting new patients
Sheridan Community Hospital Past Accepting new patients

Locations

414 Plymouth Ave NE
Grand Rapids, MI 49505
Phone (616) 454-3465

3350 Eagle Park Dr NE
Ste 102
Grand Rapids, MI 49525
Phone (616) 242-7042

301 N Main St
Sheridan, MI 48884
Phone (989) 291-3261

Interoperability endpoints

  • Direct secure messaging: mfitzgerald36702@direct.trinity-health.org

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467577817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 PLYMOUTH AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495056038",
            "telephone_number": "616-454-3465",
            "fax_number": "616-454-9004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 PLYMOUTH AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495056038",
            "telephone_number": "616-454-3465",
            "fax_number": "616-454-9004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "MARCIA",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601002935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARCIA",
            "last_name": "NAUTA",
            "middle_name": "F",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.