Joshua Wyeth
Individual provider Active NPI Physician Assistant · Onaway, MI
NPI 1588031314 · NPPES record last updated Sep 8, 2015
Key facts
- NPI
- 1588031314
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 5601007516 (MI)
- Practice address
- 21258 M 68 Hwy
Onaway, MI 49765-9692 - Phone
- (989) 733-2082
- Fax
- (989) 733-8487
- NPI assigned
- Aug 27, 2015
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 26
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- McLaren Central Michigan
Practice addresses (Care Compare)
1221 S Dr
Mount Pleasant, MI 48858-3257
Phone (989) 772-6811
2940 Health Pkwy
Mt Pleasant, MI 48858-9342
Phone (989) 779-5262
416 Connable Ave
Petoskey, MI 49770-2212
Phone (800) 248-6777
560 W Mitchell St
Petoskey, MI 49770-2276
560 W Mitchell St
Suite C70
Petoskey, MI 49770-2275
Phone (231) 487-7200
Hospital & facility affiliations
- McLaren Central Michigan
- McLaren Northern Michigan
- Munson Healthcare Otsego Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150930002941 | MI | Practitioner - Physician Assistant | 2668780230 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5601007516 | MI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thunder Bay Community Health Service, Inc | Current |
Accepting new patients | |
| McLaren Central Michigan | Current |
Accepting new patients | |
| Thunder Bay Community Health Service, Inc | Current |
Accepting new patients | |
| McLaren Central Michigan | Current |
Accepting new patients | |
| McLaren Central Michigan | Past | Accepting new patients |
Locations
11899 M 32
Atlanta, MI 49709
Phone (989) 785-4855
740 S Main St
Ste 1D
Cheboygan, MI 49721
Phone (231) 627-1449
2940 Health Pkwy
Mt Pleasant, MI 48858
Phone (989) 466-2877
1221 South Dr
Mt Pleasant, MI 48858
Phone (989) 772-6700
21258 M 68 Hwy
Onaway, MI 49765
Phone (989) 733-2082
560 W Mitchell St
Ste 160
Petoskey, MI 49770
Phone (231) 487-3118
560 W Mitchell St
Ste 340
Petoskey, MI 49770
Phone (231) 348-9710
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601007516 | MI | Yes |
Addresses
Primary practice location
21258 M 68 Hwy
Onaway, MI 49765-9692
Mailing address
PO Box 427
Hillman, MI 49746-0427
Phone (989) 354-2197
Other providers in Onaway, MI
All providers in Onaway, MI · Physician Assistant in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 8, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.