Steven Robert Mogridge, PAC
Physician Assistant in Grand Rapids, MI. Individual provider (NPI-1).
NPI number1518355437
StatusActive
Last updated in NPPESDec 1, 2025
Details
- NPI
- 1518355437
- Entity type
- Individual (NPI-1)
- Name
- Steven Robert Mogridge
- Credential
- PAC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Dec 30, 2014
- Certification date
- Dec 1, 2025
- Last updated
- Dec 1, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 5601002141 | MI | Yes |
Practice location
426 Michigan St NeGrand Rapids, MI 49503-5609
Phone 616-391-4950
Mailing address
100 Michigan St Ne # Mc845Grand Rapids, MI 49503-2560
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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