Active NPI
Matthew Kretschmer, PA
- Physician Assistant
- Ann Arbor, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601003023
- Practice address
- 1500 East Medical Ctr Dr
B1 Floor University Hospital Recp C
Ann Arbor, MI 48109-0030 - Phone
- (734) 936-4566
- NPI assigned
- Oct 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601003023 | MI | Primary |
Addresses
Primary practice location
1500 East Medical Ctr Dr
B1 Floor University Hospital Recp C
Ann Arbor, MI 48109-0030
Mailing address
3621 S State St
700 KMS Place
Ann Arbor, MI 48108
Phone (734) 936-2047
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20061218000079 | MI | Practitioner - Physician Assistant | 5597764787 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- DRS Harris Birkhill Wang Songe and Assoc PCNephron Clinic PC
Practice addresses (Care Compare)
10000 Telegraph Rd
Taylor, MI 48180-3330
Phone (313) 295-5142
1537 Monroe St
Dearborn, MI 48124-2842
Phone (313) 359-2100
18100 Oakwood Blvd
Suite 200
Dearborn, MI 48124-4085
Phone (313) 593-7301
33101 Annapolis St
Wayne, MI 48184-2405
Phone (313) 359-7600
33155 Annapolis St
Wayne, MI 48184-2405
Phone (734) 467-4000
Hospital & facility affiliations
- Corewell Health Wayne Hospital
- Beaumont Hospital - Dearborn
- Beaumont Hospital - Taylor
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5601003023 | MI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mirna Farhat MD, PLC | Past | Accepting new patients | |
| Oakwood Healthcare Inc | Past | Accepting new patients |
Organizations & group practices 4
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.
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MI
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- Dearborn, MI
- NPI 1033581434
-
- Community/Retail Pharmacy
- Westland, MI
- NPI 1033128178
Hospital & facility affiliations 4
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": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1861574022",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3621 S STATE ST",
"address_2": "700 KMS PLACE",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "48108",
"telephone_number": "734-936-2047"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 EAST MEDICAL CTR DR",
"address_2": "B1 FLOOR UNIVERSITY HOSPITAL RECP C",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481090030",
"telephone_number": "734-936-4566"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRETSCHMER",
"first_name": "MATTHEW",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601003023",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.