Individual provider Active NPI

Henrikas Erwin Vaitkevicius, PA

  • Medical Physician Assistant
  • Grand Rapids, MI
National Provider Identifier
1710086574
Registry record updated Nov 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5601002391 Issued in MI
Practice address
100 Michigan NE
Grand Rapids, MI 49503
Phone
(616) 391-1680
NPI assigned
Sep 21, 2006
Last updated
Nov 9, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2009

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 5601002391 MI Primary

Addresses

Primary practice location

100 Michigan NE
Grand Rapids, MI 49503

Mailing address

PO Box 3536
Grand Rapids, MI 49501-3536
Phone (616) 975-1845

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
002391MIMDOptometrist
5601002391MIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wood County Emergency Physicians Inc Past Accepting new patients
Emergency Care Specialists PC Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
Paul Oliver Memorial Hospital Past Accepting new patients
Lansing Urgent Care, PLC Past Accepting new patients

Organizations & group practices 5

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257724800000",
    "number": "1710086574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3536",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495013536",
            "telephone_number": "616-975-1845",
            "fax_number": "616-975-1845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49503",
            "telephone_number": "616-391-1680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAITKEVICIUS",
        "first_name": "HENRIKAS",
        "middle_name": "ERWIN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2009-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601002391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.