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

Individual provider Physician Assistant · NPI 1922863216

Colton Tyson, PA-C is a Physician Assistant in Grand Rapids, Michigan. Qualified in 2023, 3 years ago. Practices with Great Lakes Neurosurgical Associates PC, a 13-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
3
Licensed in
MI
In the registry since
2024
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

100 Michigan St NE
Grand Rapids, MI 49503-2560
Phone: (989) 482-1512
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601012314 (MI)

Record details

NPI number1922863216
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedFebruary 16, 2024
Last updated in NPPESFebruary 16, 2024
Certification dateFebruary 16, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Great Lakes Neurosurgical Associates Pc — 13 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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