NPIMap

Organization Active NPI

Munson Medical Center

Doing business as Munson Healthcare Kidney and Hypertension Specialists

  • Nephrology Physician
  • Traverse City, MI
National Provider Identifier
1245314541
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
MUNSON MEDICAL CENTER
Doing business as
Munson Healthcare Kidney and Hypertension Specialists
Practice address
3537 W Front St
Traverse City, MI 49684-7941
Phone
(231) 935-0338
Fax
(231) 935-0569
NPI assigned
Oct 24, 2006
Last updated
Oct 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2024

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

Authorized official

Name
Bonnie Kruszka
Title
Coo Munson Physician Network
Phone
(231) 935-4995

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

3537 W Front St
Traverse City, MI 49684-7941

Mailing address

3537 W Front St
Traverse City, MI 49684-7941
Phone (231) 935-0338

Other practice location 1

829 N Center Ave Ste 210
Gaylord, MI 49735-1599
Phone (231) 935-0338

Other practice location 2

419 S Coral St
Kalkaska, MI 49646-2503
Phone (231) 258-7530

Other identifiers 3

IdentifierTypeStateIssuer
0B86016OtherMIBCBS GROUP
110B812440OtherMIBCBS GROUP
CB9942OtherMIRAILROAD GROUP

Other names 2

  • Munson Healthcare Kidney and Hypertension Specialists Doing business as
  • Nephrology Consultants Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040108000904 MI Part B Supplier - Clinic/Group Practice 3072426287 Receives reassigned benefits from 568 practitioners
29 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Manistee, MI; Traverse City, MI; Cadillac, MI; Charlevoix, MI; Cheboygan, MI; Elk Rapids, MI; Frankfort, MI; Gaylord, MI…

Other NPIs on the same Medicare enrollment 29

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

View all 29

National Provider Directory

National Provider Directory

Locations

4062 W Royal Dr
Traverse City, MI 49684
Phone (231) 935-0338

Interoperability endpoints

  • Direct secure messaging: abecker2@direct.mhc.net
  • Direct secure messaging: edryer@direct.mhc.net
  • Direct secure messaging: jducastel@direct.mhc.net
  • Direct secure messaging: jfowler@direct.mhc.net
  • Direct secure messaging: jslocum@direct.mhc.net
  • Direct secure messaging: jstanifer@direct.mhc.net
  • Direct secure messaging: khagan2@direct.mhc.net
  • Direct secure messaging: mkidner@direct.mhc.net

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728000000000",
    "number": "1245314541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3537 W FRONT ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847941",
            "telephone_number": "231-935-0338",
            "fax_number": "231-935-0569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3537 W FRONT ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847941",
            "telephone_number": "231-935-0338",
            "fax_number": "231-935-0569"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "829 N Center Ave Ste 210",
            "address_purpose": "LOCATION",
            "city": "Gaylord",
            "state": "MI",
            "postal_code": "497351599",
            "country_code": "US",
            "telephone_number": "231-935-0338",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "419 S Coral St",
            "address_purpose": "LOCATION",
            "city": "Kalkaska",
            "state": "MI",
            "postal_code": "496462503",
            "country_code": "US",
            "telephone_number": "231-258-7530",
            "fax_number": "231-258-7555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MUNSON MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A",
        "authorized_official_last_name": "KRUSZKA",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_title_or_position": "COO MUNSON PHYSICIAN NETWORK",
        "authorized_official_telephone_number": "231-935-4995"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "0B86016",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "110B812440",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD GROUP",
            "identifier": "CB9942",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Munson Healthcare Kidney and Hypertension Specialists",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Nephrology Consultants",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Oct 4, 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.