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

Holly Shayne Welz Gustafson, PAC

Individual provider Physician Assistant · NPI 1922096239

Holly Shayne Welz Gustafson, PAC is a Physician Assistant in Grand Rapids, Michigan. Qualified in 2003, 23 years ago. Practices with Spectrum Health Primary Care Partners, a 2,303-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Michigan.

Years since qualifying
23
Licensed in
MI
In the registry since
2005
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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Practice location Address checks out

2770 E Beltline Ave NE
Grand Rapids, MI 49525-8614
Phone: (616) 267-8860
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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 5601004148 (MI)

Record details

NPI number1922096239
Entity typeIndividual (Type 1)
GenderFemale
Credentials PAC
Sole proprietorNo
NPI enumeratedOctober 11, 2005
Last updated in NPPESNovember 5, 2024
Certification dateNovember 5, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice Spectrum Health Primary Care Partners — 2303 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations8 on file with Medicare

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