Thomas C Nussdorfer, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301046246 Issued in MI

Practice address

3074 N US 31 S
Traverse City, MI 49684-4533

Phone

(231) 929-1234

Fax

(231) 935-0984

NPI assigned

Jun 21, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 15

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: thomas.nussdorfer@twic.eclinicaldirectplus.com

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.

• Chronic Care Management LLC

  • Family Medicine Physician
  • Traverse City, MI
  • NPI 1730506726
  Medicare reassignment NPD
• Munson Medical Center

  dba Endocrinology and Metabolism

  • Endocrinology, Diabetes & Metabolism Physician
  • Traverse City, MI
  • NPI 1083761860
  Medicare reassignment NPD
• Munson Medical Group

  dba Traverse Heart and Vascular

  • Cardiovascular Disease Physician
  • Traverse City, MI
  • NPI 1821398322
  Medicare reassignment NPD
• Munson Medical Center

  dba Munson Walk In Clinic

  • Family Medicine Physician
  • Traverse City, MI
  • NPI 1003415118
  NPD
• Munson Medical Center

  • Psychiatric Hospital Unit
  • Traverse City, MI
  • NPI 1891586103
  NPD
• Munson Medical Group

  dba MHC Cedarwoods Internal Medicine and Geriatrics

  • Geriatric Medicine (Internal Medicine) Physician
  • Traverse City, MI
  • NPI 1326801440
  NPD
• Munson Medical Group

  dba Munson Partners In Health

  • Family Medicine Physician
  • Traverse City, MI
  • NPI 1447859558
  NPD

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1134124662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3074 N US 31 S",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496844533",
            "telephone_number": "231-929-1234",
            "fax_number": "231-935-0984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3074 N US 31 S",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496844533",
            "telephone_number": "231-929-1234",
            "fax_number": "231-935-0984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUSSDORFER",
        "first_name": "THOMAS",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-21",
        "last_updated": "2023-03-07",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301046246",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY CHOICE",
            "identifier": "383530686052",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "0B81066",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THOMAS  NUSSDORFER MD",
            "identifier": "1134124662",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134124662",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US POSTAL",
            "identifier": "349386200",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4391565",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "700B810660",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIORITY HEALTH",
            "identifier": "A75289",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAP HEALTH",
            "identifier": "000000008993",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH",
            "identifier": "121591",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE CHOICES",
            "identifier": "132959",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORP NPI",
            "identifier": "1851344964",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PPOM",
            "identifier": "383530686",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI NUMBER",
            "identifier": "1134124662",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080189368",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Thomas.nussdorfer@twic.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "3074 N US 31 S",
            "city": "Traverse City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "496844533",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Novello Imaging PLC
• Novello Specialty Clinic PC
• Nrmi, LLC (NeuroRestorative Michigan)
• Nula Nutrition LLC
• Mary Nussbaum
• Noelle Gabrielle Nyquist
• Anya F Nyson, LMSW
• Abigail Marie O'Brien, FNP-C
• Andrew O'Brien, LMSW
• Jeannie O'Brien

• Family Medicine Physician in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.