Individual provider Active NPI

Matthew Kretschmer, PA

  • Physician Assistant
  • Ann Arbor, MI
National Provider Identifier
1861574022
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601003023 Issued in MI
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

Updated by the provider on Jul 8, 2007

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 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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 PCGroup PAC ID 3779495338, 63 clinicians
Nephron Clinic PCGroup PAC ID 4587833413, 6 clinicians

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 Hospital, Wayne, MI, CCN 230142
  • Beaumont Hospital - Dearborn Hospital, Dearborn, MI, CCN 230020
  • Beaumont Hospital - Taylor Hospital, Taylor, MI, CCN 230270

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601003023MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew 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.

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

Verify at the official NPI Registry.