NPIMap

Individual provider Active NPI

Kathryn Tasson, PA-C

  • Physician Assistant
  • Harrison, MI
National Provider Identifier
1760141493
Registry record updated Dec 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601011315 Issued in MI
Practice address
815 N Clare Ave Ste a
Harrison, MI 48625-8177
Phone
(989) 539-4434
NPI assigned
Dec 9, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2022

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 5601011315 MI Primary

Addresses

Primary practice location

815 N Clare Ave Ste a
Harrison, MI 48625-8177

Mailing address

815 N Clare Ave Ste a
Harrison, MI 48625-8177

Other names 1

  • Kathryn Etelamaki Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220926000632 MI Practitioner - Physician Assistant 0547646739 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mymichigan Medical Center AlmaGroup PAC ID 3375451404, 140 clinicians
Mymichigan Medical Center ClareGroup PAC ID 7012829773, 128 clinicians

Practice addresses (Care Compare)

4851 E Pickard St
Suite 1760
Mt Pleasant, MI 48858-2038
Phone (989) 775-1610

602 Beech St
Clare, MI 48617-1466
Phone (989) 802-5117

815 N Clare Ave
Suite a
Harrison, MI 48625-8177
Phone (989) 539-4434

Hospital & facility affiliations

  • Mymichigan Home Care Home health agency, Midland, MI, CCN 237015
  • Mymichigan Medical Center Clare Hospital, Clare, MI, CCN 230180
  • Mymichigan Medical Center Gladwin Hospital, Gladwin, MI, CCN 231325
  • Mymichigan Medical Center Alma Hospital, Alma, MI, CCN 230030
  • Mymichigan Medical Center Midland Hospital, Midland, MI, CCN 230222

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601011315MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Alma CurrentSince Apr 26, 2026 Accepting new patients
Mymichigan Medical Center Clare CurrentSince Sep 20, 2022 Accepting new patients
Mymichigan Medical Center Clare Physician Assistant CurrentSince Sep 20, 2022 Accepting new patients
Mymichigan Medical Center Clare Past Accepting new patients

Locations

700 W 5th St
Clare, MI 48617
Phone (989) 386-9911

815 N Clare Ave
Ste A
Harrison, MI 48625
Phone (989) 539-4434

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

4851 E Pickard St
Ste 1760
Mt Pleasant, MI 48858
Phone (989) 775-1610

Interoperability endpoints

  • Direct secure messaging: ketelamaki116221@mymichiganhealth.midirect.net

Organizations & group practices 24

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.

View all 24

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1639008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671667200000",
    "number": "1760141493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 N CLARE AVE STE A",
            "city": "HARRISON",
            "state": "MI",
            "postal_code": "486258177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 N CLARE AVE STE A",
            "city": "HARRISON",
            "state": "MI",
            "postal_code": "486258177",
            "telephone_number": "989-539-4434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TASSON",
        "first_name": "KATHRYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-09",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601011315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "ETELAMAKI",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Harrison, MI

Sources for this page

Verify at the official NPI Registry.