MR. KEITH T HUSTAK PA-C
NPI 1720149164
Physician Assistant in Grand Rapids, MI

Active since December 12, 2006
100 MICHIGAN ST NE, MC-039, GRAND RAPIDS, MI 49503(616) 486-2196 Get Directions Write a Review

NPPES record last updated: November 30, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Keith T Hustak Pa-c NPPES

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

MR. KEITH T HUSTAK PA-C (NPI 1720149164) is an individual physician assistant in Grand Rapids, Michigan, licensed in Michigan (5601004306) and active in the NPI registry since December 2006.

NPPES Registry Identity

NPI1720149164
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMR. KEITH T HUSTAKCredential: PA-C
Location Address100 MICHIGAN ST NE, MC-039Grand Rapids, MI 49503-2560
Mailing Address100 Michigan St Ne, Mc-039Grand Rapids, MI 49503-2560 · (616) 486-2196
Sole ProprietorNo
Enumeration DateDecember 12, 2006
Last NPPES UpdateNovember 30, 2015
NPI 1720149164 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in MI · 5601004306
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.
100 MICHIGAN ST NE, Grand Rapids, MI 49503

Accepted Insurance

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.

Internal Medicine
100 MICHIGAN ST NE, SUITE A721
GRAND RAPIDS, MI 49503
Anesthesiology
100 MICHIGAN ST NE
GRAND RAPIDS, MI 49503
Internal Medicine
100 MICHIGAN ST NE
GRAND RAPIDS, MI 49503
Physical Therapist
100 MICHIGAN ST NE
GRAND RAPIDS, MI 49503
Anesthesiology
100 MICHIGAN ST NE
GRAND RAPIDS, MI 49503
Emergency Medicine
100 MICHIGAN ST NE, MC 71
GRAND RAPIDS, MI 49503
Emergency Medicine
100 MICHIGAN ST NE
GRAND RAPIDS, MI 49503
Physician Assistant
100 MICHIGAN ST NE, SUITE 8861
GRAND RAPIDS, MI 49503

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 Keith Hustak's NPI number?

The NPI number for Keith Hustak is 1720149164. It was assigned to this individual provider in the NPPES registry on December 12, 2006.

Where is Keith Hustak located?

Keith Hustak practices at 100 Michigan St NE Mc-039, Grand Rapids, MI 49503. The listed phone number is (616) 486-2196.

What is Keith Hustak's specialty?

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

What insurance does Keith Hustak accept?

Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Keith Hustak 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.

When was this NPI record last updated?

The NPPES record for Keith Hustak was last updated on November 30, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.