Look up the most recent NPI and PECOS records

Gary Bissonette

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

275 Michigan St NE, Grand Rapids, MI 49503-2531

PECOS Enrollment

Based on the most recent information from CMS, provider Gary Bissonette is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 4 days ago.

Profile Details

Provider ID
1114966538
Provider Type
Individual
Full Name
Bissonette, Gary
Credential
PA

Gender
Male
Sole Proprietor
No
Enumeration Date
6/5/2006
Last Updated
1/27/2025

Contact Information

Practice Location

275 Michigan St NE, Grand Rapids, MI 49503-2531

(616) 459-8700

(616) 267-8247

Mailing Location

100 Michigan St NE # Mc845, Grand Rapids, MI 49503-2560

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 5601001392 Michigan

Gary Bissonette

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Brini, Cristina Lynn

Cerny, Ryan J

Paas, Heather Marie

Maatman, Caleb R

Kubiak, Kalin

Newkirk, Michael William

Debano, Christopher M

West, Angela Lynn

Hoff, Cody Keith

Bolenz-Geesin, Laura J