Kolleen Bartosek, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601009809 Issued in MI

Practice address

1225 W Front St Ste C
Traverse City, MI 49684-2368

Phone

(231) 642-5031

Fax

(231) 525-2306

NPI assigned

Mar 11, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• V Dermatology

  • Dermatology Physician
  • Traverse City, MI
  • NPI 1922536986

  MI

  Medicare reassignment

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

{
    "created_epoch": "1583884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1043845928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 W FRONT ST STE C",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842368",
            "telephone_number": "231-642-5031",
            "fax_number": "231-525-2306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 W FRONT ST STE C",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842368",
            "telephone_number": "231-642-5031",
            "fax_number": "231-525-2306"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "440 Cobb St",
            "address_purpose": "LOCATION",
            "city": "Cadillac",
            "state": "MI",
            "postal_code": "496012542",
            "country_code": "US",
            "telephone_number": "231-642-5031",
            "fax_number": "231-525-2306",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARTOSEK",
        "first_name": "KOLLEEN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-11",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601009809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Barrett, RN
• Virginia Ann Barrett, FNP
• Joshua David Barrick
• Lora Marie Bartnick, PA-C
• Holly Barton
• Matthew Bartz
• Leeda Bashardost, MD, MHSS, FRCPC
• Nicolette Anne Bassett, DDS
• Carly Batcha, NP
• Gary Edward Bates Jr.

• Physician Assistant in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.