NPIMap

Organization Active NPI

Bay Street Orthopaedics PLLC

  • Orthopaedic Surgery Physician
  • Petoskey, MI
National Provider Identifier
1174808992
Registry record updated Jan 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
BAY STREET ORTHOPAEDICS PLLC
Practice address
4048 Cedar Bluff Dr
Suite 1
Petoskey, MI 49770-8895
Phone
(231) 347-5155
Fax
(231) 347-6128
NPI assigned
Oct 12, 2011
Last updated
Jan 3, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2013

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

Authorized official

Name
Mark R McMurray, MDNPI 1013926948
Title
Direct Owner
Phone
(231) 347-5155

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary
Orthopaedic Hand Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0106X
Orthopaedic Foot and Ankle Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XX0004X
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

4048 Cedar Bluff Dr
Suite 1
Petoskey, MI 49770-8895

Mailing address

4048 Cedar Bluff Dr
Suite 1
Petoskey, MI 49770-8895
Phone (231) 347-5155

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120814000211 MI Part B Supplier - Clinic/Group Practice 4688864788 Receives reassigned benefits from 22 practitioners
Practice locations: Cheboygan, MI; Traverse City, MI; St Ignace, MI; Rogers City, MI; Petoskey, MI; Gaylord, MI; Charlevoix, MI

National Provider Directory

National Provider Directory

Locations

810 S Main St
Cheboygan, MI 49721
Phone (231) 627-9921

4048 Cedar Bluff Dr
Ste 1PO
Petoskey, MI 49770

Practitioners & affiliated clinicians

Practitioners 22

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.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1318377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357171200000",
    "number": "1174808992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4048 CEDAR BLUFF DR",
            "address_2": "SUITE 1",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497708895",
            "telephone_number": "231-347-5155",
            "fax_number": "231-347-6128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4048 CEDAR BLUFF DR",
            "address_2": "SUITE 1",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497708895",
            "telephone_number": "231-347-5155",
            "fax_number": "231-347-6128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAY STREET ORTHOPAEDICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-12",
        "last_updated": "2013-01-03",
        "status": "A",
        "authorized_official_last_name": "MCMURRAY",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DIRECT OWNER",
        "authorized_official_telephone_number": "231-347-5155",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petoskey, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.