Individual provider Active NPI

Michael Engel, DO

  • Psychiatry Physician
  • Traverse City, MI
National Provider Identifier
1366400475
Registry record updated Sep 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
5101007720 Issued in MI
Practice address
4620 US 31 N
Traverse City, MI 49686-3757
Phone
(231) 938-2010
Fax
(231) 938-2012
NPI assigned
May 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 5101007720 MI Primary

Addresses

Primary practice location

4620 US 31 N
Traverse City, MI 49686-3757

Mailing address

PO Box 213
Cadillac, MI 49601-0213
Phone (231) 775-6076

Other identifiers 3

IdentifierTypeStateIssuer
2733152MedicaidMI
112733152MedicaidMI
2652810384OtherMIBLUE CROSS BLUE SHIELD

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
I20040323000556 MI Practitioner - PsychiatryPractitioner - Neuropsychiatry 7719878354 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Neuropsychiatry
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Engel Mind Body Psychiatry PLLCGroup PAC ID 3870680895, 2 clinicians

Practice addresses (Care Compare)

3990 M 72
Williamsburg, MI 49690-9359
Phone (231) 938-2010

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
007720MIMDCounselor
5101007720MIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Engel Mind Body Psychiatry PLLC Psychiatry CurrentSince Jan 1, 2000 Accepting new patients
North Country Community Mental Health PastSince Apr 1, 2003 Accepting new patients

Locations

4620 US 31 N
Traverse City, MI 49686
Phone (231) 938-2010

3990 M 72 E
Williamsburg, MI 49690
Phone (231) 938-2010

Organizations & group practices 2

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": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190764800000",
    "number": "1366400475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 213",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496010213",
            "telephone_number": "231-775-6076",
            "fax_number": "231-775-0027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4620 US 31 N",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863757",
            "telephone_number": "231-938-2010",
            "fax_number": "231-938-2012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGEL",
        "first_name": "MICHAEL",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2007-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "5101007720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2733152",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112733152",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "2652810384",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.