Matthew David Paradiso, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

5601007034 Issued in MI

Practice address

47601 Grand River Ave
Providence Park Hospital
Novi, MI 48374

Phone

(248) 465-4100

NPI assigned

Jun 5, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mparadiso468917@direct.hfhs.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.

• McLaren Bay Region

  • Family Medicine Physician
  • Bay City, MI
  • NPI 1508131087

  Physician Assistant

  Medicare reassignment NPD
• McLaren Flint

  • General Practice Physician
  • Flint, MI
  • NPI 1275807372

  Physician Assistant

  Medicare reassignment NPD
• Beaumont Medical Group Hospital -Based Services

  • Hospitalist Physician
  • Royal Oak, MI
  • NPI 1427567858
  Medicare reassignment
• General Radiology Associates, P.C.

  • Diagnostic Radiology Physician
  • Mount Clemens, MI
  • NPI 1801801519
  Medicare reassignment
• McLaren Central Michigan

  • General Acute Care Hospital
  • Mt Pleasant, MI
  • NPI 1245266063
  Medicare reassignment
• McLaren Hospital Group

  • Emergency Medicine Physician
  • Flint, MI
  • NPI 1942026174
  Medicare reassignment
• McLaren Medical Group

  • Family Medicine Physician
  • Lapeer, MI
  • NPI 1346396066
  Medicare reassignment
• McLaren Bay Region

  • Psychiatry Physician
  • Bay City, MI
  • NPI 1942560339
  NPD
• McLaren Central Michigan

  • Family Medicine Physician
  • Mount Pleasant, MI
  • NPI 1710235775
  NPD
• McLaren Central Michigan

  • Rural Health Clinic/Center
  • Gladwin, MI
  • NPI 1841812989
  NPD
• McLaren Flint

  • Social Worker
  • Flint, MI
  • NPI 1356480685
  NPD
• McLaren Medical Group

  • Diagnostic Radiology Physician
  • Lapeer, MI
  • NPI 1073650750
  NPD

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

{
    "created_epoch": "1401926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1710390950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 N VERMONT AVE",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480671461",
            "telephone_number": "586-524-9837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47601 GRAND RIVER AVE",
            "address_2": "PROVIDENCE PARK HOSPITAL",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "48374",
            "telephone_number": "248-465-4100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "468 Cadieux Rd",
            "address_purpose": "LOCATION",
            "city": "Grosse Pointe",
            "state": "MI",
            "postal_code": "482301507",
            "country_code": "US",
            "telephone_number": "313-473-1605",
            "fax_number": "313-473-1934",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARADISO",
        "first_name": "MATTHEW",
        "middle_name": "DAVID",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-05",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MI",
            "license": "5601007034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mparadiso85446@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "468 Cadieux Rd",
            "city": "Grosse Pointe",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482301507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Anuja Pandey
• Amanda Panin, M.ED., BCBA
• Maria Panopoulos
• Marucina Papa Vicente
• Courtney Paquette
• Andrew Paran
• Paraskevi Orfanou, MD PLLC
• Lauralee Parcher
• Stephanie Pardo
• Kavita Ketul Parikh, RPH

• Surgical Physician Assistant in Novi, MI
• Providers in Novi, MI by specialty
• Surgical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.