Individual provider Active NPI

Roger Holowach

  • Physician Assistant
  • Petoskey, MI
National Provider Identifier
1902748411
Registry record updated Apr 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
516 Kalamazoo Ave
Petoskey, MI 49770-2743
Phone
(231) 340-4945
NPI assigned
Apr 6, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2026

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 Primary

Addresses

Primary practice location

516 Kalamazoo Ave
Petoskey, MI 49770-2743

Mailing address

516 Kalamazoo Ave
Petoskey, MI 49770-2743
Phone (231) 340-4945

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1775433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775433600000",
    "number": "1902748411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 KALAMAZOO AVE",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702743",
            "telephone_number": "231-340-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 KALAMAZOO AVE",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702743",
            "telephone_number": "231-340-4945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLOWACH",
        "first_name": "ROGER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-04-06",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petoskey, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.