Colton Tyson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601012314 Issued in MI

Practice address

100 Michigan St NE
Grand Rapids, MI 49503-2560

Phone

(989) 482-1512

NPI assigned

Feb 16, 2024

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

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

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Great Lakes Neurosurgical Associates PCGroup PAC ID 5890691182, 13 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Michigan Health - West Hospital, Wyoming, MI, CCN 230236

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: ctyson154099@direct.metrohealth.net

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.

• Great Lakes Neurosurgical Associates, PC

  • Neurological Surgery Physician
  • Grand Rapids, MI
  • NPI 1366590929
  Medicare reassignment Care Compare group
• Sheridan Community Hospital

  • Emergency Medicine Physician
  • Sheridan, MI
  • NPI 1528090594
  Medicare reassignment NPD (past)
• Ecs Western Michigan PC

  • Emergency Medicine Physician
  • Grand Rapids, MI
  • NPI 1992281000
  Medicare reassignment
• Visionary Medical Services PC

  • Emergency Medicine Physician
  • Grand Rapids, MI
  • NPI 1538216569
  Medicare reassignment
• Great Lakes Neurosurgical Associates, PC

  • Durable Medical Equipment & Medical Supplies
  • Grand Rapids, MI
  • NPI 1306366810
  NPD (past)
• Sheridan Community Hospital

  • Rural Health Clinic/Center
  • Sheridan, MI
  • NPI 1740372754
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Metropolitan Hospital

  • General Acute Care Hospital
  • Wyoming, MI
  • NPI 1619923919
  Care Compare affiliation

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

{
    "created_epoch": "1708041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1922863216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 BARLOW ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863304",
            "telephone_number": "989-482-1512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "989-482-1512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYSON",
        "first_name": "COLTON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-16",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601012314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Lena Marie Tyrna
• Jodi Tyron
• Patrick Tyrrell, DO
• Noah Tyska
• Marie Tysman, MD
• Jamia Janay Tyson
• Yalandria Tyson
• Kelsi Anne Tyszko
• Kathrin Udell
• Michael Udell, PA-C

• Physician Assistant in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2024; 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.

Verify at the official NPI Registry.