Individual provider Active NPI

Nicholas Matthew Winiarski, PA-C

  • Medical Physician Assistant
  • Grand Rapids, MI
National Provider Identifier
1770145542
Registry record updated Jul 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
4100 Embassy Dr SE
Grand Rapids, MI 49546-2416
Phone
(616) 957-7706
NPI assigned
Jul 2, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2019

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 Primary

Addresses

Primary practice location

4100 Embassy Dr SE
Grand Rapids, MI 49546-2416

Mailing address

4100 Embassy Dr SE
Grand Rapids, MI 49546-2416

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
I20190911000908 MI Practitioner - Physician Assistant 8628307055 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
97.48 of 100Reported as group
Quality
89.26
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cherry Street Services, Inc CurrentSince Nov 28, 2022 Accepting new patients
Cherry Street Services, Inc. CurrentSince Nov 28, 2022 Accepting new patients
Cherry Street Health Services Past Accepting new patients

Locations

550 Cherry St SE
Grand Rapids, MI 49503
Phone (616) 235-7272

2303 Kalamazoo Ave SE
Ste 200
Grand Rapids, MI 49507
Phone (616) 965-8379

2303 Kalamazoo Ave SE
Grand Rapids, MI 49507
Phone (616) 242-6400

1003 N Lafayette St
Greenville, MI 48838
Phone (616) 225-9650

1611 Oak Ave
Muskegon, MI 49442
Phone (231) 724-6050

2929 Burlingame Ave SW
Wyoming, MI 49509
Phone (616) 965-8333

Interoperability endpoints

  • Direct secure messaging: nicholas.winiarski.p1@direct.cherryhealth.nextgenshare.com

Organizations & group practices 6

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": "1562025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562025600000",
    "number": "1770145542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 EMBASSY DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 EMBASSY DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462416",
            "telephone_number": "616-957-7706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINIARSKI",
        "first_name": "NICHOLAS",
        "middle_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-02",
        "last_updated": "2019-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.