Individual provider Active NPI

Roche J Featherstone, M.D.

  • Specialist
  • Traverse City, MI
National Provider Identifier
1215958673
Registry record updated May 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
4301057988 Issued in MI
Practice address
1221 Sixth St Ste 300
Traverse City, MI 49684-2360
Phone
(231) 935-2400
Fax
(231) 935-2424
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 4301057988 MI Primary

Addresses

Primary practice location

1221 Sixth St Ste 300
Traverse City, MI 49684-2360

Mailing address

1221 Sixth St Ste 300
Traverse City, MI 49684-2360
Phone (231) 935-2400

Other identifiers 1

IdentifierTypeStateIssuer
103277969MedicaidMI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address roche.featherstone@gts.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20071022000379 MI Practitioner - General Surgery 3779573001 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Wayne State University School of Medicine, 1995
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)

701 W Front St
Suite 200
Traverse City, MI 49684-2287
Phone (231) 346-4000

Hospital & facility affiliations

  • Munson Home Care Home health agency, Traverse City, MI, CCN 237025
  • Munson Medical Center Hospital, Traverse City, MI, CCN 230097
  • Paul Oliver Memorial Hospital Hospital, Frankfort, MI, CCN 231300
  • Kalkaska Memorial Health Center Hospital, Kalkaska, MI, CCN 231301
  • Munson Healthcare Otsego Memorial Hospital Hospital, Gaylord, MI, CCN 230133
  • Charlevoix Area Hospital Hospital, Charlevoix, MI, CCN 231322

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
30 of 100Reported as group
Quality
0
Promoting interoperability
100
Improvement activities
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy13
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301057988MIMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Medical Center Current Accepting new patients
Munson Medical Center CurrentSince Jun 1, 2007 Accepting new patients
Munson Medical Center CurrentSince Jun 1, 2007 Accepting new patients
Munson Medical Center Past Accepting new patients
Munson Medical Center Past Accepting new patients

Locations

2513 Momentum Pl
Chicago, IL 60689
Phone (231) 935-8031

4100 Park Forest Dr
Traverse City, MI 49684
Phone (231) 392-8900

1221 Sixth St
Ste 300
Traverse City, MI 49684
Phone (231) 392-0640

701 W Front St
Ste 200
Traverse City, MI 49684
Phone (231) 346-4000

1400 Medical Campus Dr
Traverse City, MI 49684
Phone (231) 935-8000

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

Organizations & group practices 5

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1215958673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 SIXTH ST STE 300",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842360",
            "telephone_number": "231-935-2400",
            "fax_number": "231-935-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 SIXTH ST STE 300",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842360",
            "telephone_number": "231-935-2400",
            "fax_number": "231-935-2424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEATHERSTONE",
        "first_name": "ROCHE",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MI",
            "license": "4301057988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103277969",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "roche.featherstone@gts.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "1221 Sixth St Ste 300",
            "city": "Traverse City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "496842360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.