Andrew Doorn, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA2017-0088 Issued in NM

Practice address

1105 Sixth St
Traverse City, MI 49684-2345

Phone

(231) 935-7514

Fax

(231) 392-0039

NPI assigned

Sep 29, 2017

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

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

Specialty

Physician Assistant

Education

Western Michigan Un Homer Stryker School of Med, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Munson Medical CenterGroup PAC ID 3072426287, 377 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Munson Medical Center Hospital, Traverse City, MI, CCN 230097

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Munson Medical Center

  dba Endocrinology and Metabolism

  • Endocrinology, Diabetes & Metabolism Physician
  • Traverse City, MI
  • NPI 1083761860
  Medicare reassignment Care Compare group
• Munson Medical Center

  dba Munson Hematology Oncology Consultants

  • Hematology & Oncology Physician
  • Traverse City, MI
  • NPI 1649579764
  NPD
• Munson Medical Center

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

  dba Urgent Care-UCN

  • Family Medicine Physician
  • Traverse City, MI
  • NPI 1881623031
  NPD (past)
• Familycare Associates,PA

  • Family Medicine Physician
  • Las Cruces, NM
  • NPI 1821161407
  NPD (past)

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

• Munson Medical Center

  • General Acute Care Hospital
  • Traverse City, MI
  • NPI 1952307852
  Care Compare affiliation

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

{
    "created_epoch": "1506643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1144739491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4351 E LOHMAN AVE STE 200",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880118260",
            "telephone_number": "575-522-4940",
            "fax_number": "575-522-4932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 SIXTH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842345",
            "telephone_number": "231-935-7514",
            "fax_number": "231-392-0039"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4351 E Lohman Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Las Cruces",
            "state": "NM",
            "postal_code": "880118260",
            "country_code": "US",
            "telephone_number": "575-522-4940",
            "fax_number": "575-522-4932",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "217 S Madison St",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496842321",
            "country_code": "US",
            "telephone_number": "231-392-8400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1221 Sixth St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496842359",
            "country_code": "US",
            "telephone_number": "231-935-0322",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1221 Sixth St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496842360",
            "country_code": "US",
            "telephone_number": "231-935-0322",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3537 W Front St Ste E",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496847943",
            "country_code": "US",
            "telephone_number": "231-935-5880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOORN",
        "first_name": "ANDREW",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-29",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2017-0088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jill Marie Donberg, MACOM, DIPL. OM
• Melissa Ann Donick-Rousse, RN
• Diane K. Donley, M.D.
• Allee J Donnelly, BEHAVIOR TECHNICIAN
• Kelly R Donovan, DO
• Daniel James Dorrance
• Robert M Dotterrer, MD
• Carrie Douglas
• Mary Kathryn Douglas, PAC
• Bruce G Douglass, PHD

• 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 Feb 28, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.