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GAVIN O'BRIEN
NPI 1003689183
Physician Assistant in Grand Rapids, MI

Active since November 01, 2023PECOS EnrolledAccepts Medicare Assignment
770 KENMOOR AVE SE STE 100, GRAND RAPIDS, MI 49546(616) 272-3533(616) 259-4839 Get Directions Write a Review

NPPES record last updated: April 7, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 7, 2026, Nov 1, 2023 (2 updates tracked since 2023).

About Gavin O'brien NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GAVIN O'BRIEN (NPI 1003689183) is an individual physician assistant in Grand Rapids, Michigan and active in the NPI registry since November 2023. He is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1003689183
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameGAVIN O'BRIEN
Location Address770 KENMOOR AVE SE STE 100Grand Rapids, MI 49546-8602
Mailing Address801 Rosehill RdJackson, MI 49202-1762 · (517) 212-2008 · Fax (517) 212-9023
Phone(616) 272-3533
Fax(616) 259-4839
Sole ProprietorYes
Medical School CMSOtherGraduated 2025
Enumeration DateNovember 1, 2023
Last NPPES UpdateApril 7, 20262 updates tracked since enumeration
NPPES CertifiedApril 7, 2026
✔ NPI 1003689183 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
770 KENMOOR AVE SE STE 100, Grand Rapids, MI 49546
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Gavin O'brien is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8820573843
PECOS Enrollment IDI20260327002147
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49546 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.74 typical visit price
range $54.34 – $166.68
Typical copayment $21.18 (range $13.58 – $41.67)
Most-billed visit code 99203
Established Patient
$68.07 typical visit price
range $17.09 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRITTANY J DEVRIES AGNP
Nurse Practitioner (Adult Health)
770 KENMOOR AVE SE STE 100
GRAND RAPIDS, MI 49546
Kent County (616) 272-3533
ERIN KUCHAREK A-GNP-C
Nurse Practitioner (Primary Care)
770 KENMOOR AVE SE STE 100
GRAND RAPIDS, MI 49546
Kent County (517) 212-2008
SAMUEL TERRANOVA NP
Nurse Practitioner (Primary Care)
770 KENMOOR AVE SE STE 100
GRAND RAPIDS, MI 49546
Kent County (616) 272-3533
WILLIAM H DUKES MD
Family Medicine
770 KENMOOR AVE SE STE 100
GRAND RAPIDS, MI 49546
Kent County (616) 272-3533
MR. JEREMY RICHARD HERR MS, FNP, APNP
Nurse Practitioner (Family)
770 KENMOOR AVE SE STE 100
GRAND RAPIDS, MI 49546
Kent County (616) 272-3533
CORINNA LEE BALENTINE FNP-C
Nurse Practitioner (Family)
770 KENMOOR AVE SE STE 100
GRAND RAPIDS, MI 49546
Kent County (616) 272-3533
MS. EMILY ELIZA PYNE FNP-C
Nurse Practitioner (Family)
770 KENMOOR AVE SE STE 100
GRAND RAPIDS, MI 49546
Kent County (616) 272-3533
ALEXANDRA DORIOT
Nurse Practitioner (Family)
770 KENMOOR AVE SE STE 100
GRAND RAPIDS, MI 49546
Kent County (616) 272-3533

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gavin O'brien's NPI number?

The NPI number for Gavin O'brien is 1003689183. It was assigned to this individual provider in the NPPES registry on November 1, 2023.

Where is Gavin O'brien located?

Gavin O'brien practices at 770 Kenmoor Ave SE Ste 100, Grand Rapids, MI 49546. The listed phone number is (616) 272-3533.

What is Gavin O'brien's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Gavin O'brien enrolled in Medicare?

Yes. Gavin O'brien is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Gavin O'brien was last updated on April 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.