Physician Healthcare Network, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PHYSICIAN HEALTHCARE NETWORK, PC

Practice address

3350 Gratiot Blvd
Marysville, MI 48040-2121

Phone

(810) 364-4000

Fax

(810) 364-5995

NPI assigned

May 17, 2006

Last updated

Aug 4, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mimma Cusumano

Title

Director of Finance

Phone

(810) 385-8081

Specialties & licenses 11

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 40

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Christopher J Borgiel, M.D.

  • Family Medicine Physician
  • Fort Gratiot, MI
  • NPI 1316914245
  Medicare reassignment Care Compare group NPD
• Maison Burr-Meldrum

  • Family Nurse Practitioner
  • Marysville, MI
  • NPI 1033953773
  Medicare reassignment Care Compare group NPD
• Pietro Cavataio, M.D.

  • Family Medicine Physician
  • Lenox, MI
  • NPI 1134195258
  Medicare reassignment Care Compare group NPD
• Antonino G Colombo, M.D.

  • Family Medicine Physician
  • Lenox, MI
  • NPI 1598867491
  Medicare reassignment Care Compare group NPD
• John Domenico Colombo, MD

  • Family Medicine Physician
  • Marysville, MI
  • NPI 1720158579
  Medicare reassignment Care Compare group NPD
• Tara Elaine Fletcher, FNP

  • Family Nurse Practitioner
  • Lenox, MI
  • NPI 1902474778
  Medicare reassignment Care Compare group NPD
• Lauren Lee Gauthier, NP-C

  • Family Nurse Practitioner
  • Lenox, MI
  • NPI 1558025635
  Medicare reassignment Care Compare group NPD
• Geri Lynn Grossi, NP

  • Family Nurse Practitioner
  • Port Huron, MI
  • NPI 1992125223
  Medicare reassignment Care Compare group NPD
• Katherine Holdwick, FNP-C

  • Family Nurse Practitioner
  • Lenox, MI
  • NPI 1912400136
  Medicare reassignment Care Compare group NPD
• Beverlie Houser, AGPCNP-BC

  • Gerontology Nurse Practitioner
  • Fort Gratiot, MI
  • NPI 1003204660
  Medicare reassignment Care Compare group NPD
• Shannon Lacovic, FNP-C

  • Family Nurse Practitioner
  • Lenox, MI
  • NPI 1780121145
  Medicare reassignment Care Compare group NPD
• Farrukh Zaman Naqvi, M.D.

  • Family Medicine Physician
  • Fort Gratiot, MI
  • NPI 1053399642
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785801600000",
    "number": "1750334405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3050 COMMERCE DR",
            "address_2": "BILLING AND ADMINISTRATION",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480593819",
            "telephone_number": "810-385-4441",
            "fax_number": "810-385-1951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 GRATIOT BLVD",
            "city": "MARYSVILLE",
            "state": "MI",
            "postal_code": "480402121",
            "telephone_number": "810-364-4000",
            "fax_number": "810-364-5995"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4190 24th Ave Ste 204",
            "address_purpose": "LOCATION",
            "city": "Fort Gratiot",
            "state": "MI",
            "postal_code": "480593884",
            "country_code": "US",
            "telephone_number": "810-216-1000",
            "fax_number": "810-216-3138",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "36267 26 Mile Rd Ste 3",
            "address_purpose": "LOCATION",
            "city": "Lenox",
            "state": "MI",
            "postal_code": "480483253",
            "country_code": "US",
            "telephone_number": "586-716-1371",
            "fax_number": "586-716-4855",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4190 24th Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Gratiot",
            "state": "MI",
            "postal_code": "480593882",
            "country_code": "US",
            "telephone_number": "810-989-7788",
            "fax_number": "810-989-7799",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2425 Military St Bldg 2",
            "address_purpose": "LOCATION",
            "city": "Port Huron",
            "state": "MI",
            "postal_code": "480606692",
            "country_code": "US",
            "telephone_number": "810-984-5700",
            "fax_number": "810-984-1886",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1231 Pine Grove Ave Ste 2A",
            "address_purpose": "LOCATION",
            "city": "Port Huron",
            "state": "MI",
            "postal_code": "480603500",
            "country_code": "US",
            "telephone_number": "810-982-8742",
            "fax_number": "810-984-8291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PHYSICIAN HEALTHCARE NETWORK, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A",
        "authorized_official_last_name": "CUSUMANO",
        "authorized_official_first_name": "MIMMA",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "810-385-8081"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750334405",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ramica Pesta, DC
• Latyrrell Pettitt
• Talisha Pettitt
• PGS D-Provider Dentistry PLLC
• Physician Healthcare Network, PC
• Cynthia L Pittman
• Jessica Plum
• Katelyn Marie Pokoj
• Port Huron Bone and Joint Surgery PC
• Ashley Elizabeth Porter

• Family Medicine Physician in Marysville, MI
• Providers in Marysville, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.