Individual provider Active NPI

Matthew Brotherton, P.A.

  • Physician Assistant
  • Mt Pleasant, MI
National Provider Identifier
1700623840
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4851 E Pickard St Ste 1000
Mt Pleasant, MI 48858-2041
Phone
(989) 956-9069
NPI assigned
Jul 15, 2024
Last updated
Jul 15, 2024By the provider in NPPES
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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 Primary

Addresses

Primary practice location

4851 E Pickard St Ste 1000
Mt Pleasant, MI 48858-2041

Mailing address

4000 Wellness Dr
Midland, MI 48670-2000

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
I20240926000145 MI Practitioner - Physician Assistant 6103367412 Reassigns benefits to 4 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Alma CurrentSince Sep 19, 2024 Accepting new patients
Mymichigan Medical Center West Branch CurrentSince Sep 19, 2024 Accepting new patients
Mymichigan Medical Center West Branch CurrentSince Sep 19, 2024 Accepting new patients
Mymichigan Medical Center Clare CurrentSince Sep 19, 2024 Accepting new patients
West Branch Regional Medical Center Current Accepting new patients
Mymichigan Medical Center Alma CurrentSince Sep 19, 2024 Accepting new patients
Mymichigan Medical Center Clare CurrentSince Sep 19, 2024 Accepting new patients
Mymichigan Medical Center Alpena CurrentSince Sep 19, 2024 Accepting new patients

Locations

300 E Warwick Dr
Alma, MI 48801
Phone (989) 463-0104

1501 W Chisholm St
Alpena, MI 49707
Phone (989) 356-7000

703 N McEwan St
Clare, MI 48617
Phone (989) 802-5000

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

4851 E Pickard St
Ste 1000
Mt Pleasant, MI 48858
Phone (989) 956-9069

2463 S M 30
West Branch, MI 48661
Phone (517) 345-3660

Interoperability endpoints

  • Direct secure messaging: mbrotherton141351@mymichiganhealth.midirect.net

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1721001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1700623840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 WELLNESS DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486702000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4851 E PICKARD ST STE 1000",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488582041",
            "telephone_number": "989-956-9069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROTHERTON",
        "first_name": "MATTHEW",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "U",
        "enumeration_date": "2024-07-15",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, MI

Sources for this page

Verify at the official NPI Registry.