Individual provider Active NPI

Thomas Freeman Jr., MD

  • Orthopaedic Surgery Physician
  • Traverse City, MI
National Provider Identifier
1063947406
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
1063947406 Issued in MI
Practice address
4045 W Royal Dr
Traverse City, MI 49684-8965
Phone
(231) 935-0900
Fax
(833) 471-4024
NPI assigned
Apr 24, 2017
Last updated
Dec 19, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 1063947406 MI Primary

Addresses

Primary practice location

4045 W Royal Dr
Traverse City, MI 49684-8965

Mailing address

4045 W Royal Dr
Traverse City, MI 49684-8965
Phone (231) 935-0900

Other practice location 1

1215 21st Ave S
suite #4200
Nashville, TN 37232-0014
Phone (615) 322-7878

Other practice location 2

419 S Coral St
Kalkaska, MI 49646-2503
Phone (231) 258-7506

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
I20230711002135 MI Practitioner - Orthopedic Surgery 5294194015 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Vanderbilt University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Great Lakes Orthopaedic Center PCGroup PAC ID 1759371826, 36 clinicians
Kalkaska Memorial Health CenterGroup PAC ID 3577536002, 57 clinicians

Practice addresses (Care Compare)

1400 Mercy Dr
Suite 100
Muskegon, MI 49444-1833
Phone (231) 733-1326

4045 W Royal Dr
Traverse City, MI 49684-8965
Phone (231) 935-0900

419 S Coral St
Kalkaska, MI 49646-2503
Phone (231) 258-7500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)39

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1063947406MIMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kalkaska Memorial Health Center Current Accepting new patients
Kalkaska Memorial Health Center CurrentSince Sep 1, 2023 Accepting new patients
Kalkaska Memorial Health Center CurrentSince Sep 1, 2023 Accepting new patients
Great Lakes Orthopaedic Center, P.C. Orthopaedic Surgery CurrentSince Sep 1, 2023 Accepting new patients

Locations

419 S Coral St
Kalkaska, MI 49646
Phone (231) 258-7500

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

3663 N Country Dr
Traverse City, MI 49684
Phone (231) 252-1228

4045 W Royal Dr
Traverse City, MI 49684
Phone (231) 935-0900

Interoperability endpoints

  • Direct secure messaging: thomas.freeman.1@27291.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1492992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1063947406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4045 W ROYAL DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496848965",
            "telephone_number": "231-935-0900",
            "fax_number": "833-471-4024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 W ROYAL DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496848965",
            "telephone_number": "231-935-0900",
            "fax_number": "833-471-4024"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 21st Ave S",
            "address_2": "suite #4200",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372320014",
            "country_code": "US",
            "telephone_number": "615-322-7878",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "419 S Coral St",
            "address_purpose": "LOCATION",
            "city": "Kalkaska",
            "state": "MI",
            "postal_code": "496462503",
            "country_code": "US",
            "telephone_number": "231-258-7506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "THOMAS",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-24",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "1063947406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.