Timothy Norman Tetzlaff, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

TT007907 Issued in MI

Practice address

560 Osborn Boulevard
Sault Sainte Marie, MI 49783

Phone

(906) 632-1800

Fax

(906) 632-2199

NPI assigned

Jun 1, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ttetzlaff146130@mymichiganhealth.midirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mymichigan Medical Center Sault

  • Emergency Medical Services (Emergency Medicine) Physician
  • Sault Sainte Marie, MI
  • NPI 1639190382
  Medicare reassignment
• Mymichigan Medical Center Sault

  • Anesthesiology Physician
  • Sault Sainte Marie, MI
  • NPI 1457305674
  NPD
• Mymichigan Medical Center Sault

  • Anatomic Pathology & Clinical Pathology Physician
  • Sault Sainte Marie, MI
  • NPI 1518819739
  NPD
• Mymichigan Medical Center Sault

  • Family Medicine Physician
  • Sault Sainte Marie, MI
  • NPI 1699832279
  NPD
• Mymichigan Medical Center Sault

  dba Chippewa County War Memorial Hospital

  • Skilled Nursing Facility
  • Sault Sainte Marie, MI
  • NPI 1346307931
  NPD (past)
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362614400000",
    "number": "1326040544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 OSBORN BOULEVARD",
            "city": "SAULT SAINTE MARIE",
            "state": "MI",
            "postal_code": "49783",
            "telephone_number": "906-632-1800",
            "fax_number": "906-632-2199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 OSBORN BOULEVARD",
            "city": "SAULT SAINTE MARIE",
            "state": "MI",
            "postal_code": "49783",
            "telephone_number": "906-632-1800",
            "fax_number": "906-632-2199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TETZLAFF",
        "first_name": "TIMOTHY",
        "middle_name": "NORMAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2013-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "TT007907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2694733",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tendercare Sault Ste Marie Inc. (Tendercare Sault Ste Marie)
• Christa A Tepper, CRNA
• James D Tessmer
• Teter Orthotics & Prosthetics Inc (Hanger Clinic)
• Daniel Timothy Tetzlaff, PSYD, JD
• Sharron V Thomas, LMSW
• Joseph Thompson
• Kylie Darlene Thompson
• Laura Thompson, LPC
• Randy Timbol

• Family Medicine Physician in Sault Sainte Marie, MI
• Providers in Sault Sainte Marie, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.