Individual provider Active NPI

Matthew Michael McDonell, NP

  • Nurse Practitioner
  • Okemos, MI
National Provider Identifier
1730338393
Registry record updated Jul 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704249339 Issued in MI
Practice address
2205 Jolly Rd
Suite B
Okemos, MI 48864-3983
Phone
(517) 347-4085
Fax
(517) 347-4170
NPI assigned
Sep 18, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704249339 MI Primary

Addresses

Primary practice location

2205 Jolly Rd
Suite B
Okemos, MI 48864-3983

Mailing address

PO Box 1239
Troy, MI 48099-1239
Phone (248) 824-6600

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
I20090116000079 MI Practitioner - Nurse Practitioner 2567525579 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sparrow Specialty HospitalGroup PAC ID 2466347638, 4 clinicians

Practice addresses (Care Compare)

1215 E Michigan Ave
Lansing, MI 48912-1811
Phone (517) 364-4841

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704249339MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sparrow Ionia Hospital CurrentSince Dec 1, 2017 Accepting new patients
Edward W. Sparrow Hospital Association Current Accepting new patients
Sparrow Ionia Hospital CurrentSince Dec 1, 2017 Accepting new patients
Vpa PC Current Accepting new patients
Sparrow Ionia Hospital Current Accepting new patients
Vpa PC Current Accepting new patients
Vpa PC CurrentSince Jun 9, 2014 Accepting new patients
Vpa PC CurrentSince Jun 9, 2014 Accepting new patients
Sparrow Clinton Hospital Current Accepting new patients
Edward W. Sparrow Hospital Association CurrentSince May 1, 2016 Accepting new patients
Vituity - Michigan Em PC CurrentSince Oct 1, 2021 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

8175 Reliable Pkwy
Chicago, IL 60686

321 E Harris St
Charlotte, MI 48813
Phone (517) 541-5840

550 E Washington St
Ionia, MI 48846
Phone (616) 523-1600

3565 S State Rd
Ionia, MI 48846
Phone (616) 523-1355

1215 E Michigan Ave
#8W
Lansing, MI 48912
Phone (517) 364-2614

1210 W Saginaw St
Lansing, MI 48915
Phone (517) 364-7180

1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080

716 N Clippert St
Lansing, MI 48912
Phone (517) 253-4000

800 E Columbia St
Mason, MI 48854
Phone (517) 244-8900

2205 Jolly Rd
Ste B
Okemos, MI 48864
Phone (517) 347-4085

2725 Airview Blvd
Ste 105
Portage, MI 49002
Phone (269) 349-8386

805 S Oakland St
Saint Johns, MI 48879
Phone (989) 224-6881

500 Kirts Blvd
Ste 200
Troy, MI 48084
Phone (248) 824-6060

500 Kirts Blvd
Troy, MI 48084
Phone (214) 824-6000

500 Kirts Blvd
Ste 100
Troy, MI 48084
Phone (214) 824-6000

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1221696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404950400000",
    "number": "1730338393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1239",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480991239",
            "telephone_number": "248-824-6600",
            "fax_number": "855-618-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 JOLLY RD",
            "address_2": "SUITE B",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488643983",
            "telephone_number": "517-347-4085",
            "fax_number": "517-347-4170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONELL",
        "first_name": "MATTHEW",
        "middle_name": "MICHAEL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-18",
        "last_updated": "2014-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704249339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Okemos, MI

Sources for this page

Verify at the official NPI Registry.