Northern Lakes Community Mental Health Authority

A Medicare group practice based in Traverse City, MI: 3 NPIs enrolled under one PECOS associate control ID (PAC ID 8022921154), with 25 clinicians.

Medicare enrollment

Medicare enrollment files
PAC ID
8022921154The PECOS associate control ID: one enrolled organization, which may hold several NPIs
Provider type
Part B Supplier - Clinic/Group Practice
Enrolled in
MI
Enrollments
3
Group size
19 cliniciansAs Care Compare reports it
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Practice locations
9In 4 places

Enrollment records 3

Enrollment IDStateProvider typeNPI
O20031106000085 MI Part B Supplier - Clinic/Group Practice 1518068071
O20031117000682 MI Part B Supplier - Clinic/Group Practice 1669572657
O20170602002042 MI Part B Supplier - Clinic/Group Practice 1417481136

NPIs in this group 3

NPPES NPI Registry

These NPI records belong to the same enrolled organization. Each has its own page.

Practice locations

Locations on the Medicare enrollment

Clinicians 25

Clinicians who reassign their Medicare benefits to this group (25) or whom Care Compare lists as members (19).

Sources for this page