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Munson Medical Center

Organization Active NPI Audiologist · Traverse City, MI

NPI 1306097167 · NPPES record last updated Oct 4, 2024

Key facts

NPI
1306097167
Entity type
Organization (NPI type 2)
Primary specialty
Audiologist 231H00000X
Legal business name
MUNSON MEDICAL CENTER
Practice address
550 Munson Ave
Traverse City, MI 49686-3580
Phone
(231) 935-8686
NPI assigned
Oct 9, 2008
Organization subpart
No

Authorized official

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

Other NPIs with the same Medicare PAC ID 11

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

Practitioners 378

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

View all 378

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20100824000601 MI Part B Supplier - Clinic/Group Practice 3072426287 Receives reassigned benefits from 7 practitioners
Practice locations: Elmira, MI; Traverse City, MI

National Provider Directory

Tax ID family
Leroy Futterer MD (28 organizations share this tax ID)

Locations

1105 Sixth St
Ste 103
Traverse City, MI 49684
Phone (231) 935-6455

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist
Group: 193400000X SINGLE SPECIALTY GROUP		 231H00000X Yes

Addresses

Primary practice location

550 Munson Ave
Traverse City, MI 49686-3580

Mailing address

1105 Sixth St
Traverse City, MI 49684-2345

Other practice location 1

1104 Cass St
Traverse City, MI 49684-3236
Phone (231) 935-8686

Other identifiers

IdentifierTypeStateIssuer
640B827230OtherMIBLUE CROSS

Other providers in Traverse City, MI

All providers in Traverse City, MI · Audiologist in Michigan

Sources for this page

Verify at the official NPI Registry.