ANDREA NIKKO MATSUMOTO
NPI 1619536935
Nurse Practitioner - Acute Care in Detroit, MI

Q: What is Andrea Matsumoto's NPI number?

The NPI number for Andrea Matsumoto is 1619536935. It was assigned to this individual provider in the NPPES registry on June 11, 2019.

Q: What is Andrea Matsumoto's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Q: When was this NPI record last updated?

The NPPES record for Andrea Matsumoto was last updated on July 11, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.

Active since June 11, 2019PECOS EnrolledAccepts Medicare Assignment

2799 W GRAND BLVD, DETROIT, MI 48202(313) 916-2600 Get Directions Write a Review

NPPES record last updated: July 11, 2019. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 11, 2019, Jun 11, 2019 (2 updates tracked since 2019).

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About Andrea Nikko Matsumoto NPPES

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

ANDREA NIKKO MATSUMOTO (NPI 1619536935) is an individual acute care provider in Detroit, Michigan, licensed in Michigan (4704306565) and active in the NPI registry since June 2019. She is enrolled in Medicare PECOS, is affiliated with Henry Ford Macomb Hospital, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1619536935

Entity TypeIndividualFemale

Primary Taxonomy363LA2100X

Provider Legal NameANDREA NIKKO MATSUMOTO

Location Address2799 W GRAND BLVDDetroit, MI 48202-2608

Mailing Address28536 Lake Park Dr WFarmington Hills, MI 48331-4620 · (248) 921-5986

Phone(313) 916-2600

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateJune 11, 2019

Last NPPES UpdateJuly 11, 20192 updates tracked since enumeration

✔ NPI 1619536935 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2100X

License✔ Licensed in MI · 4704306565

Also ListedRegistered Nurse · OncologyTaxonomy 163WX0200X · License 4704306565 (MI)

2799 W GRAND BLVD, Detroit, MI 48202

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and more.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

Andrea Nikko Matsumoto 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 ID4981932506

PECOS Enrollment IDI20190821000621

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

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.

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.

41 services31 patients

Hospital Affiliations CMS Care Compare 3

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

Henry Ford Macomb Hospital

Acute Care Hospitals · Clinton Township, MI

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230047

Location15855 Nineteen Mile RdClinton Township, MI 48038 · Macomb County

Emergency services Birthing friendly

Henry Ford Health Hospital

Acute Care Hospitals · Detroit, MI

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230053

Location2799 W Grand BlvdDetroit, MI 48202 · Wayne County

Emergency services Birthing friendly

Henry Ford Health Wyandotte Hospital

Acute Care Hospitals · Wyandotte, MI

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230146

Location2333 Biddle AveWyandotte, MI 48192 · Wayne County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48202 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

$90.76 typical visit price

range $58.04 – $177.36

Typical copayment $22.69 (range $14.51 – $44.34)

Most-billed visit code 99203

Established Patient

$102.35 typical visit price

range $18.32 – $143.49

Typical copayment $25.58 (range $4.58 – $35.87)

Most-billed visit code 99214

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.

HENRY FORD HOSPITAL

General Acute Care Hospital