Individual provider Active NPI

Timothy Gawronski, PA

  • Physician Assistant
  • Muskegon, MI
National Provider Identifier
1972517183
Registry record updated Mar 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601004031 Issued in MI
Practice address
1500 E Sherman Blvd
Muskegon, MI 49444-1849
Phone
(231) 672-3883
NPI assigned
Jul 27, 2006
Last updated
Mar 28, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2012

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 5601004031 MI Primary

Addresses

Primary practice location

1500 E Sherman Blvd
Muskegon, MI 49444-1849

Mailing address

PO Box 1847
Muskegon, MI 49443-1847
Phone (231) 727-4444

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
I20040806001238 MI Practitioner - Physician Assistant 6305818766 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Partners Sub-Specialty ServicesGroup PAC ID 3274504105, 33 clinicians

Practice addresses (Care Compare)

1277 Mercy Dr
Muskegon, MI 49444-4605
Phone 23167261862

1560 E Sherman Blvd
Suite 250
Muskegon, MI 49444-1854
Phone (231) 672-8145

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601004031MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Physician Network Physician Assistant CurrentSince Oct 1, 2015 Accepting new patients
Emergency Health Partners Muskegon Past Accepting new patients
Spectrum Health Primary Care Partners Past Accepting new patients
Emergency Health Partners Grand Haven PLC Past Accepting new patients

Locations

1310 Wisconsin St
Ste 200
Grand Haven, MI 49417
Phone (616) 296-1640

1500 E Sherman Blvd
Muskegon, MI 49444
Phone (231) 672-3027

1560 E Sherman Blvd
Muskegon, MI 49444
Phone (231) 672-4886

1560 E Sherman Blvd
Ste 250
Muskegon, MI 49444
Phone (231) 672-8145

2006 Holton Rd
North Muskegon, MI 49445
Phone (231) 672-3333

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13864/brand/1/csg/1/fhir/r4
  • Direct secure messaging: tgawronski36754@direct.trinity-health.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332892800000",
    "number": "1972517183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1847",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494431847",
            "telephone_number": "231-727-4444",
            "fax_number": "231-727-4571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E SHERMAN BLVD",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441849",
            "telephone_number": "231-672-3883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAWRONSKI",
        "first_name": "TIMOTHY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2012-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

Verify at the official NPI Registry.