Individual provider Active NPI

Mark V Galan, M.D.

  • Gastroenterology Physician
  • Traverse City, MI
National Provider Identifier
1023184819
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MG072049 Issued in MI
Practice address
4100 Park Forest Dr
Suite 208
Traverse City, MI 49684-7331
Phone
(231) 935-5710
Fax
(231) 935-9045
NPI assigned
Nov 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MG072049 MI Primary

Addresses

Primary practice location

4100 Park Forest Dr
Suite 208
Traverse City, MI 49684-7331

Mailing address

4100 Park Forest Dr
Suite 208
Traverse City, MI 49684-7331
Phone (231) 935-5710

Other practice location 1

224 Park Ave
Frankfort, MI 49635-9658
Phone (231) 835-2088

Other identifiers 2

IdentifierTypeStateIssuer
4596099MedicaidMI
OB81010OtherMIBCBSM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040715000098 MI Practitioner - GastroenterologyPractitioner - Internal Medicine 1355320250 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Wayne State University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Munson Medical CenterGroup PAC ID 3072426287, 377 clinicians

Practice addresses (Care Compare)

224 Park Ave
Frankfort, MI 49635-9658
Phone (231) 352-2200

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy155
Upper gastrointestinal (GI) endoscopy for acid reflux155

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MG072049MIMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Medical Center CurrentSince Jul 8, 2024 Accepting new patients
Digestive Health Associates of Northern Michigan, P.C. Gastroenterology CurrentSince Jul 1, 2004 Accepting new patients
Munson Medical Center CurrentSince Jul 8, 2024 Accepting new patients
Munson Medical Center Current Accepting new patients
Munson Medical Center Past Accepting new patients

Locations

2513 Momentum Pl
Chicago, IL 60689
Phone (231) 935-8031

224 Park Ave
Frankfort, MI 49635
Phone (231) 352-2200

4100 Park Forest Dr
Ste 208
Traverse City, MI 49684
Phone (231) 392-8705

1400 Medical Campus Dr
Traverse City, MI 49684
Phone (231) 935-8000

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1023184819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 PARK FOREST DR",
            "address_2": "SUITE 208",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847331",
            "telephone_number": "231-935-5710",
            "fax_number": "231-935-9045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 PARK FOREST DR",
            "address_2": "SUITE 208",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847331",
            "telephone_number": "231-935-5710",
            "fax_number": "231-935-9045"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "224 Park Ave",
            "address_purpose": "LOCATION",
            "city": "Frankfort",
            "state": "MI",
            "postal_code": "496359658",
            "country_code": "US",
            "telephone_number": "231-835-2088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GALAN",
        "first_name": "MARK",
        "middle_name": "V",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-26",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": "MG072049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4596099",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "OB81010",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.