HOLLY NOELLE HNETYNKA (PA-C) – Physician Assistant, NPI 1114703634

HOLLY NOELLE HNETYNKA (PA-C) is a healthcare provider. based in Shepherd, Michigan. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 5601011982 (MI). The NPI Number for HOLLY NOELLE HNETYNKA (PA-C) is 1114703634

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
HOLLY NOELLE HNETYNKA (PA-C)
NPI
1114703634
Phone
Not provided
Address
322 E WRIGHT AVE
Enumeration Date
1 September 2023
Last Update Date
1 September 2023

Doctor Profile

Medical School Name
CENTRAL MICHIGAN COLLEGE OF MEDICINE
Secondary Phone
-
Graduation Year
2023 (3 years ago)
PAC ID
0749636538
Group Practice PAC ID
7113836701
Professional Enrollment ID
I20231031001603
Address ID
MI488119693CA406XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

6,066 PHYSICIAN ASSISTANT in MI

Provider Addresses for HOLLY NOELLE HNETYNKA (PA-C)

  • 322 E WRIGHT AVE

    SHEPHERD, MI 488839375

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 13 Open Payments records for all available years, with a total value of $211.

Total Amount is formed as General ($211) + Research ($0) + Ownership ($0) = $211.

Last reported payment date: 2024-12-19 • Largest payer in this snapshot: Otsuka America Pharmaceutical, Inc. ($63).

Total Amount

$211

General + Research + Ownership

Payments

13

Total payment records

General Amount

$211

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-19

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-10-31

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20231031001603IPhysician AssistantMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48883)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7113836701View full group profile
NameSpecialtyState
Internal MedicineMI
-MI
Family PracticeMI
Physician AssistantMI
Hospitalist, Internal MedicineMI
Certified Registered Nurse Anesthetist (Crna)MI
-MI
Orthopedic SurgeryMI
Emergency MedicineIL
Clinical Social WorkerMI

Reviews

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Frequently asked questions

What NPI should I save for HOLLY NOELLE HNETYNKA (PA-C)?
Save NPI 1114703634 if you need a stable reference for HOLLY NOELLE HNETYNKA (PA-C).
Does this profile mean HOLLY NOELLE HNETYNKA (PA-C) is currently active?
Yes — HOLLY NOELLE HNETYNKA (PA-C) appears active in the national provider directory.
Does HOLLY NOELLE HNETYNKA (PA-C) list a primary specialty?
If you are matching referrals, note Physician Assistant for HOLLY NOELLE HNETYNKA (PA-C). Clinical services aligned with this taxonomy classification.
What location shows for HOLLY NOELLE HNETYNKA (PA-C)?
We surface Shepherd, Michigan for HOLLY NOELLE HNETYNKA (PA-C) based on available NPPES addresses.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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