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

Individual provider Medical Physician Assistant · NPI 1053838169

Daniel Simon Stout, PA-C is a Physician Assistant in Grand Rapids, Michigan. Qualified in 2017, 9 years ago. Practices with Center for Physical Rehabilitation Inc, a 344-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
9
Licensed in
MI
In the registry since
2017
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

669 Stocking Ave NW
Grand Rapids, MI 49504-5176
Phone: (616) 235-1480
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 5601008348 (MI)

Record details

NPI number1053838169
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 29, 2017
Last updated in NPPESAugust 29, 2017

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Center For Physical Rehabilitation Inc — 344 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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