GRANT WILLIAM MATHISON – Orthopaedic Surgery Physician, NPI 1629482708

GRANT WILLIAM MATHISON is a healthcare provider. based in Grand rapids, Michigan. specializing in ORTHOPEDIC SURGERY. They hold a License No. 4301105237 (MI). The NPI Number for GRANT WILLIAM MATHISON is 1629482708

Main info

Male
12 Years Of Experience
Accepts Medicare Assignment
Name
GRANT WILLIAM MATHISON
NPI
1629482708
Phone
(616) 685-6920
Address
300 Lafayette Ave SE
Enumeration Date
17 June 2014
Last Update Date
30 July 2020

Doctor Profile

Medical School Name
UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Secondary Phone
9529938700
Graduation Year
2014 (12 years ago)
PAC ID
0648496257
Group Practice PAC ID
7911819438
Professional Enrollment ID
I20200921001338
Address ID
MN553375713BU14000DRXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience55
Completeness75
Years active:11State licenses:2Digital endpointsOther names

1,082 ORTHOPEDIC SURGERY in MI

Provider Addresses for GRANT WILLIAM MATHISON

  • 300 Lafayette Ave SE

    Suite 3200

    Grand Rapids, MI 495034692

    Phone: (616) 685-6920

    Type: Location

  • 1415 SAINT FRANCIS AVE

    SHAKOPEE, MN 553793374

    Phone: (952) 993-7750

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $53.

Total Amount is formed as General ($53) + Research ($0) + Ownership ($0) = $53.

Last reported payment date: 2024-06-12 • Largest payer in this snapshot: Skeletal Dynamics Inc ($31).

Total Amount

$53

General + Research + Ownership

Payments

2

Total payment records

General Amount

$53

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-06-12

Latest reported date

Top Companies

Largest payers in this snapshot

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: 2020-09-21

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
I20200921001338IOrthopedic SurgeryMNTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
J0702Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg7733$0
99213Established patient office or other outpatient visit, 20-29 minutes7561$0
99203New patient office or other outpatient visit, 30-44 minutes4747$0
20600Aspiration and/or injection of fluid from small joint2419$0
20550Injection into tendon or ligament2013$0
View full utilization report →

Insurance plans in this area (ZIP 49503)

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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: 7911819438View full group profile
NameSpecialtyState
O B S T E T R I C S/ G Y N E C O L O G YMN
Family PracticeMN
-MN
Pulmonary Disease, Critical Care (Intensivists), Internal MedicineMN
Cardiac ElectrophysiologyMN
Family PracticeMN
Physician AssistantMN
Physical Therapist In Private PracticeMN
Physician AssistantMN
D E R M A T O L O G YMN

Reviews

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Frequently asked questions

What NPI should I save for GRANT WILLIAM MATHISON?
Save NPI 1629482708 if you need a stable reference for GRANT WILLIAM MATHISON.
Is GRANT WILLIAM MATHISON's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What does GRANT WILLIAM MATHISON treat or focus on?
Patients typically see GRANT WILLIAM MATHISON under the specialty Orthopaedic Surgery Physician. Clinical services aligned with this taxonomy classification.
Where is GRANT WILLIAM MATHISON's primary listing?
We display Grand Rapids, Michigan because that is what the record indicates for GRANT WILLIAM MATHISON.
What if Grand Rapids, Michigan seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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