Amanda Marie Stark, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5151014776 Issued in MI

Practice address

8950 Professional Dr
Cadillac, MI 49601-8599

Phone

(231) 775-2493

Fax

(231) 779-7701

NPI assigned

May 20, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Michigan State University College of Osteopathic Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cadillac Family Physicians, P.C.Group PAC ID 2264405612, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Munson Home Care Home health agency, Traverse City, MI, CCN 237025
• Munson Healthcare Cadillac Hospital Hospital, Cadillac, MI, CCN 230081

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amandastark@cfp.allscriptsdirect.net

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.

• Cadillac Family Physicians, P.C.

  • Primary Care Clinic/Center
  • Cadillac, MI
  • NPI 1336299668
  Medicare reassignment Care Compare group NPD

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

• Munson Healthcare Cadillac

  • Family Medicine Physician
  • Cadillac, MI
  • NPI 1487051611

  Hospital

  Care Compare affiliation
• Munson Healthcare Cadillac

  • General Acute Care Hospital
  • Cadillac, MI
  • NPI 1841696754
  Care Compare affiliation
• Munson Home Care

  • Home Health Agency
  • Traverse City, MI
  • NPI 1326002577
  Care Compare affiliation

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

{
    "created_epoch": "1621468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1164097416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MUNSON FAMILY PRACTICE CENTER",
            "address_2": "1400 MEDICAL CAMPUS DRIVE",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "49684",
            "telephone_number": "231-935-8012",
            "fax_number": "231-935-8098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8950 PROFESSIONAL DR",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496018599",
            "telephone_number": "231-775-2493",
            "fax_number": "231-779-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-20",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5151014776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Nicole Spoering
• Alisa Sponseller, RBT
• Tristina Stahl
• Robert Stankewitz, M.D.
• Tanya Renae Stanley, LLMSW
• Diane Lyn Stearns, C,P.T.A.
• Laurie Katherine Steere, LPC
• Kayla Stefanko, DO
• Stehouwer Free Clinic
• Susan Lynn Stendel, L.L.P.C.

• Family Medicine Physician in Cadillac, MI
• Providers in Cadillac, 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 Aug 15, 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.