Mikala Rae Gualtieri, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601012938 Issued in MI

Practice address

3570 Henry St Ste 120
Norton Shores, MI 49441-4576

Phone

(231) 672-7000

NPI assigned

Dec 27, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mercy Physician NetworkGroup PAC ID 8921996307, 109 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Health Muskegon Hospital Hospital, Muskegon, MI, CCN 230066

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mgualtieri3091394@direct.trinity-health.org

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.

• Mercy Physician Network

  • Family Medicine Physician
  • Muskegon, MI
  • NPI 1023056744
  Medicare reassignment Care Compare group
• Mercy Physician Network

  • Family Medicine Physician
  • Fruitport, MI
  • NPI 1639502701
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Health Partners

  • General Acute Care Hospital
  • Muskegon, MI
  • NPI 1831132133
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1735257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1669280384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "892 COLLEGE AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494237050",
            "telephone_number": "616-510-6407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3570 HENRY ST STE 120",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494414576",
            "telephone_number": "231-672-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUALTIERI",
        "first_name": "MIKALA",
        "middle_name": "RAE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-27",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5601012938APP24",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601012938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Taylor Graham, DC
• Janet E Graham, DNP, FNP-BC
• Great Lakes Integrative Wellness
• Mackenzie Laura Greene
• Brittany Alexis Grosvenor, PA-C
• Stephanie Guimaraes
• Alyssa Gunderson, LMSW
• Katelyn C Gustafson, NP
• Hackley Professional Pharmacy, Inc
• Hackley Professional Pharmacy,Inc

• Physician Assistant in Norton Shores, MI
• Providers in Norton Shores, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.