Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Andrea Nikko Matsumoto

Individual provider Oncology Registered Nurse · NPI 1619536935

Andrea Nikko Matsumoto is a Nurse Practitioner in Detroit, Michigan. Qualified in 2019, 7 years ago. Practices with Henry Ford Health System, a 2,540-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Michigan.

Years since qualifying
7
Licensed in
MI
In the registry since
2019
Specialties on file
2

Practice location Address checks out

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone: (313) 916-2600
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 4704306565 (MI)
Oncology Registered Nurse Taxonomy 163WX0200X · Licence 4704306565 (MI)

Record details

NPI number1619536935
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 11, 2019
Last updated in NPPESJuly 11, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Henry Ford Health System — 2540 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Detroit