NPIMap

Organization Active NPI

Munson Medical Center

  • Pain Medicine (Anesthesiology) Physician
  • Traverse City, MI
National Provider Identifier
1306277553
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
MUNSON MEDICAL CENTER
Practice address
550 Munson Ave
Traverse City, MI 49686-3580
Phone
(231) 935-8540
Fax
(231) 935-8544
NPI assigned
Dec 12, 2013
Organization subpart
No

Authorized official

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

Other NPIs on the same Medicare enrollment 29

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

View all 29

Corporate family (same tax ID) 27

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

View all 27

Practitioners 16

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

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
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…

National Provider Directory

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

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X Primary

Addresses

NPPES NPI Registry

Primary practice location

550 Munson Ave
Traverse City, MI 49686-3580

Mailing address

550 Munson Ave
Traverse City, MI 49686-3580
Phone (231) 935-8540

Other names 1

NPPES NPI Registry
  • Munson Spine and Nerve Pain Treatment Center Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 4, 2024.

{
    "created_epoch": "1386806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728000000000",
    "number": "1306277553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 MUNSON AVE",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863580",
            "telephone_number": "231-935-8540",
            "fax_number": "231-935-8544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 MUNSON AVE",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863580",
            "telephone_number": "231-935-8540",
            "fax_number": "231-935-8544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUNSON MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-12",
        "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": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Munson Spine and Nerve Pain Treatment Center",
            "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 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.