NPIMap

Organization Active NPI

Traverse City Ophthalmology PLLC

Doing business as Traverse City Eye

  • Ophthalmology Physician
  • Traverse City, MI
National Provider Identifier
1225616279
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
TRAVERSE CITY OPHTHALMOLOGY PLLC
Doing business as
Traverse City Eye
Practice address
3830 W Front St
Traverse City, MI 49684-8153
Phone
(231) 935-8101
NPI assigned
Mar 31, 2021
Last updated
Mar 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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

Authorized official

Name
Josh McCaherty
Title
Practice Manager
Phone
(231) 935-8101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X Primary

Addresses

Primary practice location

3830 W Front St
Traverse City, MI 49684-8153

Mailing address

5199 N Royal Dr
Traverse City, MI 49684-9201
Phone (231) 935-8101

Other practice location 1

419 S Coral St
Kalkaska, MI 49646-2503
Phone (231) 258-7695

Other practice location 2

7800 US Highway 131 S
Cadillac, MI 49601-7080
Phone (231) 935-8101

Other names 1

  • Traverse City Eye Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210921003579 MI Part B Supplier - Clinic/Group Practice 6608273412 Receives reassigned benefits from 11 practitioners
Practice locations: Kalkaska, MI; Traverse City, MI; Cadillac, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1617148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710288000000",
    "number": "1225616279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5199 N ROYAL DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496849201",
            "telephone_number": "231-935-8101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3830 W FRONT ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496848153",
            "telephone_number": "231-935-8101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "419 S Coral St",
            "address_purpose": "LOCATION",
            "city": "Kalkaska",
            "state": "MI",
            "postal_code": "496462503",
            "country_code": "US",
            "telephone_number": "231-258-7695",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7800 US Highway 131 S",
            "address_purpose": "LOCATION",
            "city": "Cadillac",
            "state": "MI",
            "postal_code": "496017080",
            "country_code": "US",
            "telephone_number": "231-935-8101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TRAVERSE CITY OPHTHALMOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-31",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A",
        "authorized_official_last_name": "MCCAHERTY",
        "authorized_official_first_name": "JOSH",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "231-935-8101"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Traverse City Eye",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Traverse City Eye",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; 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.