Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Ethan J Lacourt, PA-C

Individual provider Physician Assistant · NPI 1003434507

Mr. Ethan J Lacourt, PA-C is a Physician Assistant in Grand Rapids, Michigan. Qualified in 2021, 5 years ago. Practices with Spectrum Health Primary Care Partners, a 2,303-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
5
Licensed in
MI
In the registry since
2020
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

275 Michigan St NE
Grand Rapids, MI 49503-2531
Phone: (616) 267-7900
Fax: (616) 267-7901
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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 5601010844 (MI)

Record details

NPI number1003434507
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 10, 2020
Last updated in NPPESDecember 10, 2024
Certification dateDecember 10, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Spectrum Health Primary Care Partners — 2303 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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