MEDICARE: ALEATHA DENISE REITSMA-MATHIAS MD

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	4301072313	MI
2	208M00000X	Hospitalist Physician	ME152672	FL

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	14857	OTHER	IA	AVERA HEALTH PLAN
2	426038405	OTHER	IA	SELECTFIRST
3	49409	OTHER	IA	SIOUX VALLEY HEALTH PLAN
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	5682027	OTHER	IA	FIRST HEALTH
7	H53025	OTHER	IA	COVENTRY HEALTH CARE
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	249977	OTHER	IA	MIDLANDS CHOICE
10	07878	OTHER	IA	BCBS - ER LOCATION
11	720911046506	OTHER	IA	PREFERRED ONE
12	9236800	OTHER	IA	DAKOTACARE
13	04-08715	OTHER	IA	MEDICA
14	2MG2S	OTHER	FL	BCBS
15	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1194786475
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEATHA DENISE REITSMA-MATHIAS MD

Provider Business Mailing Address
First Line	:	PO BOX 112019
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34108-0134
Country	:	US
Telephone Number	:	239-624-6400
Fax Number	:

Provider Business Practice Location Address
First Line	:	8001 CHALLIS RD
Second Line	:
City	:	BRIGHTON
State	:	MI
Zip	:	48116-7446
Country	:	US
Telephone Number	:	734-998-2020
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2006
Last Update Date	:	05/20/2026

8159 CHALLIS RD
BRIGHTON, MI
48116-7446

Practice Phone: 248-478-3232
Practice Fax: