NPIMap

Individual provider Active NPI

Mason Jon Witte, NP

  • Gerontology Nurse Practitioner
  • Grand Rapids, MI
National Provider Identifier
1770283988
Registry record updated Aug 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
4704351728 Issued in MI
Practice address
2902 Bradford St NE
Grand Rapids, MI 49525-6427
Phone
(616) 885-5200
NPI assigned
Mar 6, 2023
Last updated
Aug 25, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 4704351728 MI Primary

Addresses

Primary practice location

2902 Bradford St NE
Grand Rapids, MI 49525-6427

Mailing address

100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560

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
I20231227001141 MI Practitioner - Nurse Practitioner 6406206853 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northview Health Specialists, PLLCGroup PAC ID 9638422835, 24 clinicians

Practice addresses (Care Compare)

2900 Bradford St NE
Corewell Health Medical Group West
Grand Rapids, MI 49525-6427
Phone (616) 885-5000

2902 Bradford St NE
Corewell Health Medical Group West
Grand Rapids, MI 49525-6427
Phone (616) 486-6577

3152 Port Sheldon St
Hudsonville, MI 49426-9297
Phone (616) 494-5830

4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600

602 Michigan Ave
Suite 102
Holland, MI 49423-4918
Phone (616) 494-8724

770 Kenmoor Ave SE
Suite 100
Grand Rapids, MI 49546-8602
Phone (616) 272-3533

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704351728MIMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Primary Care Partners CurrentSince Aug 25, 2025 Accepting new patients
Northview Medical House Calls PLC CurrentSince Apr 6, 2024 Accepting new patients
Careconnectmd Michigan PC CurrentSince Dec 28, 2023 Accepting new patients
Northview Health Specialists, PLLC CurrentSince Nov 27, 2023 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Aug 25, 2025 Accepting new patients
Careline Hmi300 LLC CurrentSince Nov 1, 2023 Accepting new patients
Careline Palliative Care LLC Primary Care CurrentSince Apr 6, 2024 Accepting new patients
Premier Heart Associates, Inc PastSince Apr 6, 2024 Accepting new patients

Locations

3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182

3200 Greenfield Rd
Ste 300
Dearborn, MI 48120
Phone (313) 318-8208

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

2902 Bradford St NE
Grand Rapids, MI 49525
Phone (616) 486-6577

770 Kenmoor Ave SE
Ste 100
Grand Rapids, MI 49546
Phone (616) 272-3533

602 Michigan Ave
Ste 102
Holland, MI 49423
Phone (616) 392-3824

801 Rosehill Rd
Jackson, MI 49202
Phone (517) 212-2008

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

4760 Fashion Square Blvd
Ste L1
Saginaw, MI 48604
Phone (989) 282-4003

Interoperability endpoints

  • Direct secure messaging: mwitte205973@epic00.corewelldirect.org

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1678060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1770283988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2902 BRADFORD ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495256427",
            "telephone_number": "616-885-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTE",
        "first_name": "MASON",
        "middle_name": "JON",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-06",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "4704351728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.