THOMAS M MATELIC


Address: 1111 Leffingwell Ave Ne, Ste 100, Grand Rapids, MI 49525-6406
Phone: 6164597101

THOMAS M MATELIC (NPI# 1700873874) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1700873874
Entity Type Individual
Full Name THOMAS M MATELIC
Credential MD
Practice Address 1111 Leffingwell Ave Ne
Ste 100
Grand Rapids
MI 49525-6406
Practice Telephone 6164597101
Mailing Telephone 6164597101
Enumeration Date 2005-10-04
Last Update Date 2013-03-12
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207XX0005X Orthopaedic Surgery
Specialization: Sports Medicine
4301054564 MI Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
MI 103308680 05

Office Location

Street Address 1111 LEFFINGWELL AVE NE
STE 100
City GRAND RAPIDS
State MI
Zip Code 49525-6406

Providers in the same location

NPI Name Taxonomy Address Enumeration
1437151834 William G Brinkmeier Physician Assistant 1111 Leffingwell Ave Ne, Ste 100, Grand Rapids, MI 49525-6406 2005-08-15
1316571334 Beth A Ronda Occupational Therapist 1111 Leffingwell Ave Ne, Grand Rapids, MI 49525-6406 2020-02-28
1811535172 Kaylyn Fales Specialist/Technologist 1111 Leffingwell Ave Ne, Grand Rapids, MI 49525-6406 2019-12-18
1275170540 Marissa Marguerite Hansen Physical Therapist 1111 Leffingwell Ave Ne, Grand Rapids, MI 49525-6406 2019-12-05
1285120568 Danielle M Beaudoin Physical Therapist 1111 Leffingwell Ave Ne, Grand Rapids, MI 49525-6406 2018-07-10
1235630203 Michael D Newlin Physical Therapist 1111 Leffingwell Ave Ne, Grand Rapids, MI 49525-6406 2018-02-26
1649787128 Corey John Koll Physician Assistant 1111 Leffingwell Ave Ne, Grand Rapids, MI 49525-6406 2018-01-05
1144735093 Bradley M Griffin Occupational Therapist 1111 Leffingwell Ave Ne, Grand Rapids, MI 49525-6406 2017-12-13
1811412315 Logan M Neil Physical Therapist 1111 Leffingwell Ave Ne, Grand Rapids, MI 49525-6406 2017-08-07
1053848929 Hilary May Fredricks Physical Therapist 1111 Leffingwell Ave Ne, Grand Rapids, MI 49525-6406 2017-05-22
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1053928507 Therapy With Nicole Pllc Community/Behavioral Health 4867 E. Beltline Ave. Ne, Building #1 Lower Level, Grand Rapids, MI 49525 2020-09-29
1184242760 Christian Healthcare Specialists, Inc. Obstetrics & Gynecology 3322 Beltline Court Ne, Suite 1, Grand Rapids, MI 49525 2020-07-09
1174154645 Amy Vanderslik Case Manager/Care Coordinator 3310 Eaglecrest Park Dr. Ne, Suite 100, Grand Rapids, MI 49525 2020-02-03
1477195246 Epic Discoveries LLC Counselor 4867 E. Beltline Ave Ne, Grand Rapids, MI 49525 2019-10-14
1598228959 Kim Scherencel Lmsw Counseling Social Worker 3280 Beltline Ne, Grand Rapids, MI 49525 2019-04-11
1821558958 Mindful Trajectories Social Worker 3280 Beltlne Ct Ne, Grand Rapids, MI 49525 2019-03-24
1104380518 Julianne Lettinga, Ma Lpc Counseling Counselor 3280 East Beltline Ct Ne, Grand Rapids, MI 49525 2019-01-30
1396227229 Christopher Scot Doucette Social Worker 2064 Airway St Ne, Grand Rapids, MI 49525 2018-09-06
1568976017 Amy K. Deyoung, Dds, Ms, PC Pediatric Dentistry Dentist 3297 Eagle Run Dr. Ne, Grand Rapids, MI 49525 2017-11-20
1407389604 Kelly Jo Crabb Social Worker 4829 E Beltline Ave Ne Ste 100, Grand Rapids, MI 49525 2017-04-05
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Taxonomy Information

Taxonomy Code 207XX0005X
Grouping Allopathic & Osteopathic Physicians
Classification Orthopaedic Surgery
Specialization Sports Medicine

Taxonomy Definition

An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1215075106 Carl Henry Wierks Orthopaedic Surgery 1000 E Paris Ave Se Ste 215, Grand Rapids, MI 49546-3680 2007-02-02
1003909524 Mfb Professional Services Inc Orthopaedic Surgery 1155 E. Paris, Ste 200, Grand Rapids, MI 49546 2006-10-02
1245331941 James R Lebolt Orthopaedic Surgery 4100 Lake Dr Se, Ste 300, Grand Rapids, MI 49546-8292 2006-09-26
1578509303 John H Healey Jr. Orthopaedic Surgery 350 Lafayette Ave Se, Fourth Floor, Grand Rapids, MI 49503-4656 2006-06-21
1730125428 Timothy D Henne Orthopaedic Surgery 350 Lafayette Ave Se, 5th Floor, Grand Rapids, MI 49503-4656 2006-06-21
1932174109 Michigan Orthopaedics and Sports Medicine, PC Orthopaedic Surgery 2911 Knapp St Ne, Suite A, Grand Rapids, MI 49525 2006-02-21
1720076219 Peter C Theut Orthopaedic Surgery 1111 Leffingwell Ave Ne, Ste 100, Grand Rapids, MI 49525-6406 2005-10-10

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1821472861 Oakland University Orthopaedic Surgery 201 Athletics Ctr, Rochester, MI 48309 2015-07-18
1689871576 Stacy Ann Frye Orthopaedic Surgery 3960 Patient Care Dr Ste 113, Lansing, MI 48911-4279 2007-07-02
1598878266 Abdallah Simaika Orthopaedic Surgery 2797 Applegate Rd, Po Box 55, Applegate, MI 48401-9752 2006-08-16
1689662405 Richard M Howell Orthopaedic Surgery 370 N 120th Ave, Holland, MI 49424-2196 2005-10-06
1235121138 Steven T Plomaritis Orthopaedic Surgery 28001 Schoenherr Rd, Suite 3, Warren, MI 48088-4396 2005-08-17
1457961716 Justin Michael Schupbach Orthopaedic Surgery 24 Frank Lloyd Wright Dr Lbby A, Ann Arbor, MI 48105-9484 2020-08-03
1053945923 Pure Performance Orthopedics & Sports Medicine Orthopaedic Surgery 27207 Lahser Rd Ste 108, Southfield, MI 48034-2168 2020-02-28
1396377131 Msu Health Care Inc. Orthopaedic Surgery 4660 S Hagadorn Rd Ste 420, East Lansing, MI 48823-5353 2020-02-10
1477011591 Shannon Elizabeth Manno Orthopaedic Surgery 26850 Providence Pkwy Ste 260, Novi, MI 48374-1256 2019-03-07
1659895993 Alexander S Russell Orthopaedic Surgery 2799 W Grand Blvd, Detroit, MI 48202 2017-07-28
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Competitor

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City GRAND RAPIDS
Zip Code 49525

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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