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

Mikala Rae Gualtieri, PA

Individual provider Family Medicine Physician · NPI 1669280384

Mikala Rae Gualtieri, PA is a Physician Assistant in Norton Shores, Michigan. Qualified in 2024, 2 years ago. Practices with Mercy Physician Network, a 110-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Michigan.

Years since qualifying
2
Licensed in
MI
In the registry since
2024
Specialties on file
2
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

3570 Henry St Ste 120
Norton Shores, MI 49441-4576
Phone: (231) 672-7000
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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 5601012938 (MI)
Family Medicine Physician Taxonomy 207Q00000X · Licence 5601012938APP24 (MI)

Record details

NPI number1669280384
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedDecember 27, 2024
Last updated in NPPESJanuary 14, 2025
Certification dateJanuary 14, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Mercy Physician Network — 110 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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