NPIMap

Little Traverse Bay Bands of Odawa Indians

A Medicare group practice based in Petoskey, MI: 2 NPIs enrolled under one PECOS associate control ID (PAC ID 8820995368), with 16 clinicians.

Medicare enrollment

Medicare enrollment files
PAC ID
8820995368The PECOS associate control ID: one enrolled organization, which may hold several NPIs
Provider type
Part A Provider - Federally Qualified Health Center (FQHC), Part B Supplier - Clinic/Group Practice
Enrolled in
MI
Enrollments
3
Group size
13 cliniciansAs Care Compare reports it
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Practice locations
3In 1 place

Enrollment records 3

Enrollment IDStateProvider typeNPI
O20031215000228 MI Part A Provider - Federally Qualified Health Center (FQHC) 1124052816
O20230208000810 MI Part A Provider - Federally Qualified Health Center (FQHC) 1871272583
O20110916000317 MI Part B Supplier - Clinic/Group Practice 1124052816

NPIs in this group 2

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 16

Clinicians who reassign their Medicare benefits to this group (14) or whom Care Compare lists as members (13).

Sources for this page