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NPI · 1053953273 · NPPES-sourced

Marina Matta Physician Assistant

ActivePhysician Assistant
NPI Number
1053953273
Type 1 · Individual
Taxonomy Code
363A00000X
Contact
(313) 723-2572
Primary practice line
Last Updated
About 3 months ago (Feb 2026)
Enumerated 2019-10-09
Primary practice addressMI · 48230-6224
17108 Mack Ave Ste 108Grosse Pointe Farms, MI 48230-6224
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About this NPIWhat this record shows.

NPI 1053953273 is registered to Marina Matta Physician Assistant, a Physician Assistant practising at 17108 Mack Ave Ste 108 in Grosse Pointe Farms, Michigan. Physician Assistant is a recognised medical specialty under the National Uniform Claim Committee (NUCC) taxonomy. Marina Matta Physician Assistant has been enumerated in the National Provider Identifier (NPI) registry since 2019.

Provider type
Individual (Type 1)
Status
Active
Enumerated
2019-10-09
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Medicare enrollment

This provider holds a Medicare enrollment on file with the Provider Enrollment, Chain and Ownership System (PECOS). Each enrollment carries a public Medicare Enrollment ID (ENRLMT_ID) used by billers and intermediaries.

Practitioner

Source: CMS PECOS public enrollment file.

Insurance & acceptsHow to confirm coverage.

The National Plan and Provider Enumeration System (NPPES) registry does not include commercial insurance network data, so we cannot show which plans Marina Matta Physician Assistant accepts. To confirm in-network status with your specific health plan, contact Marina Matta Physician Assistant directly at (313) 723-2572.

Frequently asked

Yes. NPI 1053953273 is registered as Active in the CMS NPPES public registry and passes the Luhn check-digit validation that all 10-digit NPIs use.

Physician Assistant is a recognised medical specialty under the National Uniform Claim Committee (NUCC) taxonomy.

The CMS NPPES Public Registry at npiregistry.cms.hhs.gov is the authoritative source. FindMyNPI mirrors this dataset and refreshes monthly. For real-time verification, you can also call the provider's office at (313) 723-2572.

An individual healthcare provider has a single Type-1 NPI for life. Organisations can hold separate Type-2 NPIs per location, specialty, or sub-entity. Marina Matta Physician Assistant is a Type-1 individual NPI.

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Quick facts

Provider typeIndividual
Taxonomy363A00000X
Last updated2026-02
Enumerated2019-10-09
StatusActive
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