NPIMap

Individual provider Active NPI

Tricia Ann McGillis, PA

  • Physician Assistant
  • Marion, MI
National Provider Identifier
1619989530
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601003629 Issued in MI
Practice address
100 W. Main St.
Marion, MI 49665
Phone
(231) 743-0150
Fax
(231) 743-0152
NPI assigned
Aug 12, 2006
Last updated
Aug 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

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 5601003629 MI Primary

Addresses

Primary practice location

100 W. Main St.
Marion, MI 49665

Mailing address

PO Box 87
Cadillac, MI 49601-0087
Phone (231) 775-6076

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051215000599 MI Practitioner - Physician Assistant 0446271647 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

100 W Main St
Marion, MI 49665-9239

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601003629MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Countryside Health, PLLC PastSince Feb 2, 2010 Accepting new patients
Asmc II, PLLC Physician Assistant Past Accepting new patients
Epmg of Michigan, P.C. Physician Assistant PastSince Aug 4, 2024 Accepting new patients
Countryside Health Clnic LLC Physician Assistant Past Accepting new patients
Four Seasons Emergency Associates, PC Physician Assistant Past Accepting new patients

Organizations & group practices 7

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.

Hospital & facility affiliations 5

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": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1619989530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 87",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496010087",
            "telephone_number": "231-775-6076",
            "fax_number": "231-775-0027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W. MAIN ST.",
            "city": "MARION",
            "state": "MI",
            "postal_code": "49665",
            "telephone_number": "231-743-0150",
            "fax_number": "231-743-0152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGILLIS",
        "first_name": "TRICIA",
        "middle_name": "ANN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-12",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601003629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, MI

Sources for this page

Verify at the official NPI Registry.