NPIMap

Organization Active NPI

Mymichigan Medical Center Tawas

Doing business as Ascension St Joseph Hospital Internal Medicine Clinic

  • Rural Health Clinic/Center
  • Tawas City, MI
National Provider Identifier
1164410841
Registry record updated Jan 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MYMICHIGAN MEDICAL CENTER TAWAS
Doing business as
Ascension St Joseph Hospital Internal Medicine Clinic
MyMichigan Internal Medicine
Practice address
295 Maple St
Suite 202
Tawas City, MI 48763-9352
Phone
(989) 362-6108
Fax
(989) 362-0161
NPI assigned
Oct 7, 2005
Last updated
Jan 14, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2026

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

Authorized official

Name
Sarah James
Title
Manager Patient Accounting
Phone
(989) 701-4734

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

295 Maple St
Suite 202
Tawas City, MI 48763-9352

Mailing address

4000 Wellness Dr
Midland, MI 48670-2000
Phone (844) 832-1956

Other names 2

  • Ascension St Joseph Hospital Internal Medicine Clinic Doing business as
  • MyMichigan Internal Medicine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050910000194 MI Part A Provider - Rural Health Clinic 9638070766 Practice locations: Tawas City, MI
O20100719000712 MI Part A Provider - Hospital 9638070766 5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tawas City, MI; Oscoda, MI; Hale, MI; Au Gres, MI

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1164410841. Details of each certification follow.

Rural health clinic certification: CCN 233986

Legal name
MYMICHIGAN MEDICAL CENTER TAWAS
Doing business as
MYMICHIGAN INTERNAL MEDICINE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 9, 1994
Last certification
Oct 21, 2024
Ownership / control type
2B
Organization structure
CorporationNon-profit
Enrollment address
295 Maple St
Ste 202
Tawas City, MI 48763-9352
Related CCNs
230100

Hospital certification: CCN 230100

Legal name
MYMICHIGAN MEDICAL CENTER TAWAS
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Apr 20, 2011
Beds
60
Ownership / control type
Hospital district or authority
Organization structure
CorporationNon-profit
Enrollment address
200 Hemlock Rd
Tawas City, MI 48763-2000
Main/Primary Hospital Location
Hospital subgroups
Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Tawas St Joseph HospitalCCN 230100 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D0897011Mymichigan Internal Medicine295 Maple Street Suite 202, Tawas City, MI 48763Certificate of waiverJan 28, 2027

National Provider Directory

National Provider Directory
Tax ID family
TSJ Health Ctr Oscoda S11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 25

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Marcia Mastracci Ditmyer Individual Corporate OfficerBoard of Directors Aug 1, 2024
Corporate OfficerBoard Member Aug 1, 2024
Bapineedu Maganti Individual Corporate Officer Aug 1, 2024
Mary Catherine Hannah Individual Corporate OfficerBoard of Directors Aug 1, 2024
Charity Higgins Individual Corporate DirectorDirector Physicians Operation Aug 18, 2015
W-2 Managing Employee Aug 18, 2015
Corporate DirectorDirector of Medical Practices Jan 1, 2017 5%
W-2 Managing EmployeeDirector of Medical Practices Jan 1, 2017 5%
Sarah James Individual W-2 Managing Employee Jul 1, 2024
Corporate OfficerManger, Provider Enrollment Oct 24, 2025
Steve Meyer Individual Corporate OfficerBoard of Directors Aug 1, 2024
Elizabeth Scribner Individual W-2 Managing Employee Aug 1, 2024
John Freel Individual Corporate OfficerBoard of Directors Aug 1, 2024
Laurilee McCord Individual OtherCredentialing Coordinator Jan 1, 2019
W-2 Managing EmployeeCredentialing Coordinator Jul 1, 2018
Samantha Hunter Individual W-2 Managing Employee May 13, 2025
W-2 Managing Employee Oct 24, 2025
Bryan R Cross Individual Corporate OfficerBoard of Directors Aug 1, 2024
Brodi Katelyn Lynch Individual Corporate OfficerBoard of Directors Aug 1, 2024
Ronald a Bays Individual Corporate OfficerBoard of Directors Aug 1, 2024
Corporate DirectorBoard of Directors Aug 1, 2024
Amanda Peirce Individual Corporate Director Aug 1, 2024
Heather Bauman Individual Corporate OfficerBoard of Directors Aug 1, 2024
Tina Church Individual Corporate Director Aug 1, 2024
Mymichigan Health Organization, Midland, MI Chain home office Operational/Managerial Control Aug 1, 2024 100%
5% Or Greater Direct Ownership Interest Aug 1, 2024 100%
Michael Erickson Individual Corporate OfficerPresident Aug 1, 2024
Mark Flegenheimer Individual Corporate OfficerBoard of Directors Aug 1, 2024
Andrew Bethune Individual Corporate OfficerBoard of Directors Aug 1, 2024
Corporate OfficerBoard Member Aug 1, 2024
Tricia Gorde Individual Corporate DirectorDirector of Operations Jan 20, 2025
Corporate DirectorDirector, Provider Enrollment Oct 24, 2025
Jimmy Greene Individual Corporate OfficerBoard of Directors Aug 1, 2024
Mymichigan Medical Center Tawas Organization, Tawas City, MI Corporation Operational/Managerial Control Aug 1, 2024 100%
Terence Moore Individual Corporate DirectorBoard Member Aug 1, 2024
Corporate OfficerBoard of Directors Aug 1, 2024
Jo S May Individual Corporate OfficerBoard of Directors Aug 1, 2024

Owners & managing parties with NPI records 11

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 7

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mymichigan Medical Center TawasTawas City, MI, CCN 230100 Hospital Operational/Managerial Control (100%) Aug 1, 2024
Mymichigan Health Park OscodaOscoda, MI, CCN 233985 Rural health clinic Operational/Managerial Control (100%) Aug 1, 2024
Mymichigan Obstretics & GynecologyTawas City, MI, CCN 238534 Rural health clinic Operational/Managerial Control (100%) Aug 1, 2024
Mymichigan Family MedicineAu Gres, MI, CCN 238570 Rural health clinic Operational/Managerial Control (100%) Aug 1, 2024
Mymichigan Family MedicineHale, MI, CCN 238538 Rural health clinic Operational/Managerial Control (100%) Oct 25, 2025
Mymichigan Family MedicineTawas City, MI, CCN 233991 Rural health clinic Operational/Managerial Control (100%) Oct 25, 2025
Mymichigan Beech Street BuildingTawas City, MI, CCN 238911 Rural health clinic Operational/Managerial Control (100%) Aug 1, 2024

Owned or controlled facilities with NPI records 8

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 30

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 30

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 204

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 204

NPI Registry JSON

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

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768348800000",
    "number": "1164410841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 WELLNESS DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486702000",
            "telephone_number": "844-832-1956",
            "fax_number": "989-633-5241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 MAPLE ST",
            "address_2": "SUITE 202",
            "city": "TAWAS CITY",
            "state": "MI",
            "postal_code": "487639352",
            "telephone_number": "989-362-6108",
            "fax_number": "989-362-0161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYMICHIGAN MEDICAL CENTER TAWAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-07",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "MANAGER PATIENT ACCOUNTING",
        "authorized_official_telephone_number": "989-701-4734"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ascension St Joseph Hospital Internal Medicine Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MyMichigan Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tawas City, MI

Sources for this page

Verify at the official NPI Registry.