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Munson Medical Center

Organization Active NPI Radiation Oncology Physician · Traverse City, MI

NPI 1376097733 · NPPES record last updated Sep 3, 2026

Key facts

NPI
1376097733
Entity type
Organization (NPI type 2)
Primary specialty
Radiation Oncology Physician 2085R0001X
License
L458593 (MI)
Legal business name
MUNSON MEDICAL CENTER
Practice address
217 S Madison Avenue
Traverse City, MI 49684-2320
Phone
(231) 392-8400
Fax
(231) 935-7126
NPI assigned
Aug 15, 2016
Organization subpart
Yes
Parent organization (as reported)
MUNSON MEDICAL CENTER

Authorized official

Name
Kathleen Marie Laraia
Title
Authorized Official
Phone
(231) 392-8400

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
O20171106000444 MI Part B Supplier - Clinic/Group Practice 3072426287 Receives reassigned benefits from 7 practitioners
Practice locations: Cadillac, MI; Grayling, MI; Traverse City, MI; Williamsburg, MI

National Provider Directory

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

Locations

1110 Sixth St
Traverse City, MI 49684
Phone (231) 392-8400

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 2085R0001X L458593 MI Yes

Addresses

Primary practice location

217 S Madison Avenue
Traverse City, MI 49684-2320

Mailing address

PO Box 84868
Chicago, IL 60689-4868
Phone (231) 392-8400

Other names

  • Munson Medical Center Radiation Oncologists Doing business as

Other providers in Traverse City, MI

All providers in Traverse City, MI · Radiation Oncology Physician in Michigan

Sources for this page

Verify at the official NPI Registry.