NPIMap

Organization Active NPI

Munson Medical Center

Doing business as Munson Medical Center Radiation Oncologists

  • Radiation Oncology Physician
  • Traverse City, MI
National Provider Identifier
1376097733
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
L458593 Issued in MI
Legal business name
MUNSON MEDICAL CENTER
Doing business as
Munson Medical Center Radiation Oncologists
Practice address
217 S Madison Avenue
Traverse City, MI 49684-2320
Phone
(231) 392-8400
Fax
(231) 935-7126
NPI assigned
Aug 15, 2016
Last updated
Sep 3, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
MUNSON MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0001X L458593 MI Primary

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 1

  • Munson Medical Center Radiation Oncologists Doing business as

Medicare participation

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

Enrollment records 1

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

Other NPIs with the same Medicare PAC ID 11

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

National Provider Directory

National Provider Directory
Tax ID family
Douglas J Coles MD32 organizations share this tax ID, including this one
Part of
Douglas J Coles MD

Other organizations with this tax ID 31

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

View all 31

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1471219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788393600000",
    "number": "1376097733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 84868",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606894868",
            "telephone_number": "231-392-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 S MADISON AVENUE",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842320",
            "telephone_number": "231-392-8400",
            "fax_number": "231-935-7126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUNSON MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MUNSON MEDICAL CENTER",
        "enumeration_date": "2016-08-15",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A",
        "authorized_official_last_name": "LARAIA",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "231-392-8400"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": "MI",
            "license": "L458593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Munson Medical Center Radiation Oncologists",
            "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 Sep 3, 2026; 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.