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

Individual provider Physician Assistant · NPI 1457724965

Eyoome K Agbley, PA-C is a Physician Assistant in Grand Rapids, Michigan. Qualified in 2012, 14 years ago. Practices with Advanced Radiology Services PC, a 252-clinician group and accepts Medicare assignment. Licensed in Indiana and Michigan.

Years since qualifying
14
Licensed in
IN, MI
In the registry since
2015
Specialties on file
2
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

3264 N Evergreen Dr NE
Grand Rapids, MI 49525-9746
Phone: (616) 363-7272
Fax: (616) 361-5828
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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 5601007847 (MI)
Physician Assistant Taxonomy 363A00000X · Licence 1001984A (IN)

Record details

NPI number1457724965
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedNovember 5, 2015
Last updated in NPPESNovember 18, 2025
Certification dateNovember 18, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Advanced Radiology Services Pc — 252 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations21 on file with Medicare

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