EVAN GERONDALE PA
NPI 1336730662
Physician Assistant - Medical in Grand Rapids, MI

Active since January 29, 2021PECOS EnrolledAccepts Medicare Assignment
1740 E PARIS AVE SE, GRAND RAPIDS, MI 49546(616) 949-5600(616) 949-6571 Get Directions Write a Review

NPPES record last updated: April 14, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 14, 2022, Jan 29, 2021 (2 updates tracked since 2021).

About Evan Gerondale Pa NPPES

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

EVAN GERONDALE PA (NPI 1336730662) is an individual medical provider in Grand Rapids, Michigan, licensed in Michigan (5601010425) and active in the NPI registry since January 2021. He is enrolled in Medicare PECOS, is affiliated with Spectrum Health, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1336730662
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameEVAN GERONDALECredential: PA
Location Address1740 E PARIS AVE SEGrand Rapids, MI 49546-6204
Mailing Address1740 E Paris Ave SeGrand Rapids, MI 49546-6204 · (616) 949-5600 · Fax (616) 949-6571
Fax(616) 949-6571
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateJanuary 29, 2021
Last NPPES UpdateApril 14, 20222 updates tracked since enumeration
NPPES CertifiedApril 14, 2022
NPI 1336730662 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License Licensed in MI · 5601010425
1740 E PARIS AVE SE, Grand Rapids, MI 49546

Other Identifiers 1

Other5601010425MI · State License

Accepted Insurance

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

Evan Gerondale Pa 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 ID5193130912
PECOS Enrollment IDI20210209000121
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.

Areas of Expertise CMS Part B claims 13

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Destruction of precancer skin growth, 2-14 growths 17003
This procedure involves removing 2-14 precancerous skin growths. The growths are treated to prevent them from potentially developing into skin cancer. The process is safe, with minimal discomfort, and promotes healthier skin.
734 services147 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
284 services268 patients
Destruction of precancer skin growth, 1 growth 17000
"Destruction of precancer skin growth" is a procedure that eliminates a single precancerous skin growth. This is done to prevent it from developing into skin cancer. The growth may be removed using various methods such as cryotherapy (freezing), laser therapy, or topical medications.
215 services200 patients
Biopsy of related skin growth, first growth 11102
A biopsy of a skin growth involves taking a small sample of the growth to examine it under a microscope. This helps determine if the growth is harmful. The procedure is typically quick, with minimal discomfort. It's a crucial step in ensuring your skin's health.
180 services175 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
84 services84 patients
Biopsy of related skin growth, each additional growth 11103
A biopsy of related skin growth is a procedure where a small piece of skin growth is removed for testing. If additional growths are identified, they may also be biopsied. This helps in diagnosing skin conditions and planning appropriate treatment.
78 services47 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Spectrum Health

Acute Care Hospitals · Grand Rapids, MI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230038
Location100 Michigan St NEGrand Rapids, MI 49503 · Kent County
Emergency services Birthing friendly

Other Providers at the Same Location NPPES 18

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

Dermatology
1740 E PARIS AVE SE
GRAND RAPIDS, MI 49546
Dermatology (MOHS-Micrographic Surgery)
1740 E PARIS AVE SE
GRAND RAPIDS, MI 49546
Nurse Practitioner
1740 E PARIS AVE SE
GRAND RAPIDS, MI 49546
Dermatology
1740 E PARIS AVE SE
GRAND RAPIDS, MI 49546
Dermatology (MOHS-Micrographic Surgery)
1740 E PARIS AVE SE
GRAND RAPIDS, MI 49546
Physician Assistant
1740 E PARIS AVE SE
GRAND RAPIDS, MI 49546
Physician Assistant
1740 E PARIS AVE SE
GRAND RAPIDS, MI 49546
Dermatology
1740 E PARIS AVE SE
GRAND RAPIDS, MI 49546

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 Evan Gerondale's NPI number?

The NPI number for Evan Gerondale is 1336730662. It was assigned to this individual provider in the NPPES registry on January 29, 2021.

Where is Evan Gerondale located?

Evan Gerondale practices at 1740 E Paris Ave SE, Grand Rapids, MI 49546. The listed phone number is (616) 949-5600.

What is Evan Gerondale's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Evan Gerondale enrolled in Medicare?

Yes. Evan Gerondale 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.

What insurance does Evan Gerondale accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Priority Health and UnitedHealthcare list Evan Gerondale as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Evan Gerondale affiliated with any hospitals?

According to CMS data, Evan Gerondale is affiliated with Spectrum Health.

When was this NPI record last updated?

The NPPES record for Evan Gerondale was last updated on April 14, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.