Individual provider Active NPI

Maggie Yavaraski, PA-C

  • Medical Physician Assistant
  • Saint Joseph, MI
National Provider Identifier
1659194207
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5601012883 Issued in MI
Practice address
1234 Napier Ave
Saint Joseph, MI 49085-2112
Phone
(269) 985-4632
NPI assigned
Nov 4, 2024
Last updated
Jan 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5601012883 MI Primary

Addresses

Primary practice location

1234 Napier Ave
Saint Joseph, MI 49085-2112

Mailing address

1234 Napier Ave
Saint Joseph, MI 49085-2112
Phone (269) 985-4632

Other practice location 1

31 N Saint Joseph Ave
Niles, MI 49120-2207
Phone (269) 985-4632

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
I20241123000185 MI Practitioner - Physician Assistant 7315472636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeland Medical PracticesGroup PAC ID 1658427042, 286 clinicians

Practice addresses (Care Compare)

1234 Napier Ave
Saint Joseph, MI 49085-2112
Phone (269) 983-8300

31 N Saint Joseph Ave
Niles, MI 49120-2207
Phone (269) 687-1436

3950 Hollywood Rd
Saint Joseph, MI 49085-9151

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Medical Practices CurrentSince Nov 18, 2024 Accepting new patients
Lakeland Medical Practices CurrentSince Nov 18, 2024 Accepting new patients

Locations

31 N Saint Joseph Ave
Niles, MI 49120
Phone (269) 428-2417

3950 Hollywood Rd
Ste 280
Saint Joseph, MI 49085
Phone (269) 408-0990

1234 Napier Ave
Saint Joseph, MI 49085
Phone (269) 982-4941

Interoperability endpoints

  • Direct secure messaging: myavaraski3088523@epic00.corewelldirect.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1730678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1659194207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 NAPIER AVE",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490852112",
            "telephone_number": "269-985-4632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 NAPIER AVE",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490852112",
            "telephone_number": "269-985-4632"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "31 N Saint Joseph Ave",
            "address_purpose": "LOCATION",
            "city": "Niles",
            "state": "MI",
            "postal_code": "491202207",
            "country_code": "US",
            "telephone_number": "269-985-4632",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YAVARASKI",
        "first_name": "MAGGIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-04",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601012883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MI

Sources for this page

Verify at the official NPI Registry.