NPIMap

Organization Active NPI

Alpine Eye Care, PC

  • Ophthalmology Physician
  • Gaylord, MI
National Provider Identifier
1215065727
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
4301405077 Issued in MI
Legal business name
ALPINE EYE CARE, PC
Practice address
350 W North St
Gaylord, MI 49735-1525
Phone
(989) 732-6455
Fax
(989) 732-1102
NPI assigned
Feb 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Authorized official

Name
Michelle Tobin
Title
Business Manager
Phone
(989) 732-6455

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 4901004074 MI
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 4901003939 MI
Ophthalmology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207W00000X 4301405077 MI Primary
Ophthalmology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207W00000X 5101016992 MI

Addresses

Primary practice location

350 W North St
Gaylord, MI 49735-1525

Mailing address

PO Box 1665
Gaylord, MI 49734-5665
Phone (989) 732-6455

Other identifiers 8

IdentifierTypeStateIssuer
180F910770OtherMIBCBS OD
1806920011OtherMIBLUE CARE NETWORK
3038315MedicaidMI
180F910760OtherMIBCBS MD
CJ0562OtherMIRAILROAD MEDICARE
900F910770OtherMIBLUE CARE NETWORK
900F910770OtherMIBCBS
1806920011OtherMIBCBS

Other names 2

  • Alpine Eye Care Doing business as
  • Jeffrey K Chaulk MD PC Former legal business name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070719000634 MI Part B Supplier - Clinic/Group Practice 6305947458 Receives reassigned benefits from 8 practitioners
Practice locations: Gaylord, MI; Cheboygan, MI; Grayling, MI
O20100930014696 MI DME Supplier - Physician - OphthalmologyDME Supplier - Optician 6305947458 Practice locations: Gaylord, MI

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Michigan350 W North St, Gaylord, MI 49735-1525(989) 732-6455 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Apr 1, 1994

National Provider Directory

National Provider Directory

Locations

724 S Main St
Ste 3
Cheboygan, MI 49721

724 S Main St
Cheboygan, MI 49721
Phone (231) 445-9119

350 W North St
Gaylord, MI 49735
Phone (517) 732-6455

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788393600000",
    "number": "1215065727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1665",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497345665",
            "telephone_number": "989-732-6455",
            "fax_number": "989-732-1102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 W NORTH ST",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497351525",
            "telephone_number": "989-732-6455",
            "fax_number": "989-732-1102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALPINE EYE CARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A",
        "authorized_official_last_name": "TOBIN",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "989-732-6455"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004074",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003939",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "4301405077",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "5101016992",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OD",
            "identifier": "180F910770",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "1806920011",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3038315",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MD",
            "identifier": "180F910760",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CJ0562",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "900F910770",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "900F910770",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1806920011",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alpine Eye Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Alpine Eye Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jeffrey K Chaulk MD PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Gaylord, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.