MATTHEW P RICCI (NPI# 1215924386) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215924386 |
| Entity Type | Individual |
| Full Name | MATTHEW P RICCI |
| Credential | PAC |
| Practice Address |
1111 Leffingwell Ave Ne Ste 100 Grand Rapids MI 49525-6406 |
| Practice Telephone | 6164597101 |
| Practice Fax Number | 6164646170 |
| Mailing Telephone | 6164597101 |
| Mailing Fax Number | 6164646170 |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2013-09-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | 5601003589 | MI | Allopathic & Osteopathic Physicians |
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
5601003589 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RR MEDICARE | P00284546 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023675287 | Matthew John Ricci | Physical Therapist | 3125 Valencia Dr, Idaho Falls, ID 83404-7575 | 2019-05-23 |
| 1083179634 | Matthew Ricci | Student in an Organized Health Care Education/Training Program | 9040 Fitzsimmons Dr, Joint Base Lewis Mcchord, WA 98431-1000 | 2019-02-07 |
| Street Address |
1111 LEFFINGWELL AVE NE STE 100 |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49525-6406 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437151834 | William G Brinkmeier | Physician Assistant | 1111 Leffingwell Ave Ne, Ste 100, Grand Rapids, MI 49525-6406 | 2005-08-15 |
| 1316571334 | Beth A Ronda | Occupational Therapist | 1111 Leffingwell Ave Ne, Grand Rapids, MI 49525-6406 | 2020-02-28 |
| 1811535172 | Kaylyn Fales | Specialist/Technologist | 1111 Leffingwell Ave Ne, Grand Rapids, MI 49525-6406 | 2019-12-18 |
| 1275170540 | Marissa Marguerite Hansen | Physical Therapist | 1111 Leffingwell Ave Ne, Grand Rapids, MI 49525-6406 | 2019-12-05 |
| 1285120568 | Danielle M Beaudoin | Physical Therapist | 1111 Leffingwell Ave Ne, Grand Rapids, MI 49525-6406 | 2018-07-10 |
| 1235630203 | Michael D Newlin | Physical Therapist | 1111 Leffingwell Ave Ne, Grand Rapids, MI 49525-6406 | 2018-02-26 |
| 1649787128 | Corey John Koll | Physician Assistant | 1111 Leffingwell Ave Ne, Grand Rapids, MI 49525-6406 | 2018-01-05 |
| 1144735093 | Bradley M Griffin | Occupational Therapist | 1111 Leffingwell Ave Ne, Grand Rapids, MI 49525-6406 | 2017-12-13 |
| 1811412315 | Logan M Neil | Physical Therapist | 1111 Leffingwell Ave Ne, Grand Rapids, MI 49525-6406 | 2017-08-07 |
| 1053848929 | Hilary May Fredricks | Physical Therapist | 1111 Leffingwell Ave Ne, Grand Rapids, MI 49525-6406 | 2017-05-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053928507 | Therapy With Nicole Pllc | Community/Behavioral Health | 4867 E. Beltline Ave. Ne, Building #1 Lower Level, Grand Rapids, MI 49525 | 2020-09-29 |
| 1184242760 | Christian Healthcare Specialists, Inc. | Obstetrics & Gynecology | 3322 Beltline Court Ne, Suite 1, Grand Rapids, MI 49525 | 2020-07-09 |
| 1174154645 | Amy Vanderslik | Case Manager/Care Coordinator | 3310 Eaglecrest Park Dr. Ne, Suite 100, Grand Rapids, MI 49525 | 2020-02-03 |
| 1477195246 | Epic Discoveries LLC | Counselor | 4867 E. Beltline Ave Ne, Grand Rapids, MI 49525 | 2019-10-14 |
| 1598228959 | Kim Scherencel Lmsw Counseling | Social Worker | 3280 Beltline Ne, Grand Rapids, MI 49525 | 2019-04-11 |
| 1821558958 | Mindful Trajectories | Social Worker | 3280 Beltlne Ct Ne, Grand Rapids, MI 49525 | 2019-03-24 |
| 1104380518 | Julianne Lettinga, Ma Lpc Counseling | Counselor | 3280 East Beltline Ct Ne, Grand Rapids, MI 49525 | 2019-01-30 |
| 1396227229 | Christopher Scot Doucette | Social Worker | 2064 Airway St Ne, Grand Rapids, MI 49525 | 2018-09-06 |
| 1568976017 | Amy K. Deyoung, Dds, Ms, PC Pediatric Dentistry | Dentist | 3297 Eagle Run Dr. Ne, Grand Rapids, MI 49525 | 2017-11-20 |
| 1407389604 | Kelly Jo Crabb | Social Worker | 4829 E Beltline Ave Ne Ste 100, Grand Rapids, MI 49525 | 2017-04-05 |
| Find all providers in zip 49525 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093028441 | Lonna Petronella Van Ast | Physician Assistant | 1022 Ada Place Dr Se, Grand Rapids, MI 49546-3786 | 2010-07-14 |
| 1285681536 | Susan G Laham | Physician Assistant | 1425 Michigan St Ne, Suite D, Grand Rapids, MI 49503-2027 | 2006-05-30 |
| 1891768065 | Paul Loh | Physician Assistant | 100 Michigan St Ne, Mc 103, Suite 8830, Grand Rapids, MI 49503-2560 | 2006-02-08 |
| 1366439432 | Michael Lee Bills | Physician Assistant | 4100 Lake Dr Se Ste 300, Grand Rapids, MI 49546-8292 | 2005-10-04 |
| 1285633172 | Adam J Geller | Physician Assistant | 1300 Michigan St Ne Ste 200, Grand Rapids, MI 49503-2029 | 2005-07-21 |
| 1649787128 | Corey John Koll | Physician Assistant | 1111 Leffingwell Ave Ne, Grand Rapids, MI 49525-6406 | 2018-01-05 |
| 1811439763 | Danielle Susan Douglass | Physician Assistant | 25 Michigan St Ne, Suite 6100, Grand Rapids, MI 49503-2515 | 2016-11-09 |
| 1982078515 | Laura E Stevenson | Physician Assistant | 1111 Leffingwell Ave Ne, Grand Rapids, MI 49525-6406 | 2015-11-19 |
| 1932570975 | Neurosurgery Health Services Plc | Physician Assistant | 414 Plymouth Ave Ne, Grand Rapids, MI 49505-6038 | 2015-10-16 |
| 1427437177 | Ian Gary Mcbain | Physician Assistant | 221 Michigan St Ne Ste 400, Grand Rapids, MI 49503-2543 | 2015-05-28 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49525 |
Please comment or provide details below to improve the information on MATTHEW P RICCI.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.