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

Individual provider Physician Assistant · NPI 1699001156

Thomas Jay Beverwyk, PA-C is a Physician Assistant in Grand Rapids, Michigan. Qualified in 2009, 17 years ago. Practices with Capitol Infectious Disease Associates, a 3-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
17
Licensed in
MI
In the registry since
2009
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

4100 Lake Dr SE Ste 205
Grand Rapids, MI 49546-8292
Phone: (515) 267-7414
Fax: (616) 267-7137
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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 5601005649 (MI)

Record details

NPI number1699001156
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 19, 2009
Last updated in NPPESJuly 21, 2021
Certification dateJuly 21, 2021

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Capitol Infectious Disease Associates — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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