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

Individual provider Medical Physician Assistant · NPI 1336730662

Evan Gerondale, PA is a Physician Assistant in Grand Rapids, Michigan. Qualified in 2020, 6 years ago. Practices with Dawm, PLC, an 18-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
6
Licensed in
MI
In the registry since
2021
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1740 E Paris Ave SE
Grand Rapids, MI 49546-6204
Phone: (616) 949-5600
Fax: (616) 949-6571
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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 5601010425 (MI)

Record details

NPI number1336730662
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJanuary 29, 2021
Last updated in NPPESApril 14, 2022
Certification dateApril 14, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Dawm, Plc — 18 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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