Individual provider Active NPI

Todd Allan Myers, MD

  • Family Medicine Physician
  • Traverse City, MI
National Provider Identifier
1245333558
Registry record updated Jun 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301078079 Issued in MI
Practice address
4343 Lands End
Traverse City, MI 49686-8061
Phone
(231) 922-1021
NPI assigned
Sep 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301078079 MI Primary

Addresses

Primary practice location

4343 Lands End
Traverse City, MI 49686-8061

Mailing address

3271 Racquet Club Dr
Vetrans Affairs Cboc
Traverse City, MI 49684-4770
Phone (231) 932-9720

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
I20040827000267 MI Practitioner - Family Practice 4082689757 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wayne State University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Great Lakes Therapy Housecalls PCGroup PAC ID 7719876580, shared by 2 NPIs, 71 clinicians

Practice addresses (Care Compare)

9731 E Cherry Bend Rd
Traverse City, MI 49684-7621
Phone (231) 941-8100

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301078079MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Medical Center Current Accepting new patients
Munson Medical Center CurrentSince May 1, 2004 Accepting new patients
Munson Medical Center CurrentSince May 1, 2004 Accepting new patients

Locations

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

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

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

550 Munson Ave
Traverse City, MI 49686
Phone (231) 935-6600

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340841600000",
    "number": "1245333558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3271 RACQUET CLUB DR",
            "address_2": "VETRANS AFFAIRS CBOC",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496844770",
            "telephone_number": "231-932-9720",
            "fax_number": "231-995-9302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 LANDS END",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496868061",
            "telephone_number": "231-922-1021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "TODD",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2012-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301078079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.