Matthew Stephen Lefevre

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601005864 Issued in MI

Practice address

13924 Wadaga Rd
Baraga, MI 49908-9204

Phone

(906) 275-5100

NPI assigned

Sep 13, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1284336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650672000000",
    "number": "1922315969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1960 US HIGHWAY 41 S",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498559795",
            "telephone_number": "906-226-6531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13924 WADAGA RD",
            "city": "BARAGA",
            "state": "MI",
            "postal_code": "499089204",
            "telephone_number": "906-275-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEFEVRE",
        "first_name": "MATTHEW",
        "middle_name": "STEPHEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-13",
        "last_updated": "2022-04-23",
        "certification_date": "2022-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601005864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Baraga, MI
• Providers in Baraga, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2022; 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.