Individual provider Active NPI

Matthew C. Stevens, P.A.C.

  • Physician Assistant
  • Alpena, MI
National Provider Identifier
1508012006
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601005333 Issued in MI
Practice address
309 W Lake St
Alpena, MI 49707-2216
Phone
(989) 358-3998
Fax
(989) 358-3735
NPI assigned
Aug 15, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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 5601005333 MI Primary

Addresses

Primary practice location

309 W Lake St
Alpena, MI 49707-2216

Mailing address

1035 W Washington Ave
Alpena, MI 49707-2929
Phone (989) 358-0673

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address matthew.stevens.p1@direct.alcona.nextgenshare.com

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
I20081024000572 MI Practitioner - Physician Assistant 1052479672 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alcona Citizens for Health IncGroup PAC ID 5991691958, 65 clinicians

Practice addresses (Care Compare)

11745 US Hwy 23 S
Alcona Health Centers Ossineke Ser
Ossineke, MI 49766-9582
Phone (989) 471-2156

177 N Barlow Rd
Harrisville, MI 48740-9607
Phone (989) 736-8157

181 N Barlow Rd
Ahc Tiger Health Extension
Harrisville, MI 48740-9607
Phone (989) 736-8716

309 W Lake St
Ahc Wildcat Extension
Alpena, MI 49707-2216
Phone (989) 358-3998

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601005333MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alcona Citizens for Health, Inc. CurrentSince Aug 25, 2008 Accepting new patients
Alcona Citizens for Health, Inc. Physician Assistant CurrentSince Aug 25, 2008 Accepting new patients
Alcona Citizens for Health Inc Past Accepting new patients

Locations

1185 US Highway 23 N
Alpena, MI 49707
Phone (989) 356-4049

309 W Lake St
Alpena, MI 49707
Phone (989) 358-3998

1035 W Washington Ave
Alpena, MI 49707

177 N Barlow Rd
Harrisville, MI 48740
Phone (989) 736-3020

Interoperability endpoints

  • Direct secure messaging: matthew.stevens.p1@direct.alcona.nextgenshare.com

Organizations & group practices 3

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": "1218758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1508012006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 W WASHINGTON AVE",
            "city": "ALPENA",
            "state": "MI",
            "postal_code": "497072929",
            "telephone_number": "989-358-0673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 W LAKE ST",
            "city": "ALPENA",
            "state": "MI",
            "postal_code": "497072216",
            "telephone_number": "989-358-3998",
            "fax_number": "989-358-3735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "MATTHEW",
        "middle_name": "C.",
        "name_prefix": "Mr.",
        "credential": "P.A.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-15",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601005333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "matthew.stevens.p1@direct.alcona.nextgenshare.com",
            "affiliation": "N",
            "address_1": "309 W Lake St",
            "city": "Alpena",
            "state": "MI",
            "country_code": "US",
            "postal_code": "497072216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Alpena, MI

Sources for this page

Verify at the official NPI Registry.