Individual provider Active NPI

Catherine B Stoddard, MD

  • Anesthesiology Physician
  • Traverse City, MI
National Provider Identifier
1376756643
Registry record updated Apr 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
4301093885 Issued in MI
Practice address
4100 Park Forest Dr
Suite 210
Traverse City, MI 49684-7331
Phone
(231) 935-5770
Fax
(231) 935-0747
NPI assigned
May 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 4301093885 MI Primary

Addresses

Primary practice location

4100 Park Forest Dr
Suite 210
Traverse City, MI 49684-7331

Mailing address

4100 Park Forest Dr
Suite 210
Traverse City, MI 49684-7331
Phone (231) 935-5770

Other identifiers 1

IdentifierTypeStateIssuer
1376756643MedicaidMI

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
I20090818000535 MI Practitioner - Anesthesiology 5193879674 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Michigan Medical School, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Munson Medical GroupGroup PAC ID 8820277015, 191 clinicians
Munson Medical CenterGroup PAC ID 3072426287, shared by 12 NPIs, 377 clinicians

Practice addresses (Care Compare)

1200 6TH St
Traverse City, MI 49684-2369
Phone (231) 935-5800

4100 Park Forest Dr
Traverse City, MI 49684-7331
Phone (231) 392-8900

Hospital & facility affiliations

  • Munson Medical Center Hospital, Traverse City, MI, CCN 230097

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Healthcare Otsego Memorial Hospital Current Accepting new patients
Munson Medical Center Current Accepting new patients
Munson Healthcare Otsego Memorial Hospital Current Accepting new patients
Munson Healthcare Otsego Memorial Hospital Current Accepting new patients
Munson Medical Group Current Accepting new patients
Munson Healthcare Otsego Memorial Hospital CurrentSince Jun 1, 2023 Accepting new patients
Munson Healthcare Otsego Memorial Hospital CurrentSince Jun 1, 2023 Accepting new patients
Munson Medical Center Anesthesiology CurrentSince Feb 1, 2025 Accepting new patients
Munson Medical Center CurrentSince Mar 1, 2020 Accepting new patients
Munson Medical Center CurrentSince Mar 1, 2020 Accepting new patients
Munson Medical Group Anesthesiology CurrentSince Sep 16, 2022 Accepting new patients
Munson Healthcare Otsego Memorial Hospital Anesthesiology CurrentSince Jun 1, 2023 Accepting new patients
Munson Medical Group CurrentSince Sep 16, 2022 Accepting new patients

Locations

2891 Momentum Pl
Chicago, IL 60689

2513 Momentum Pl
Chicago, IL 60689
Phone (231) 935-8031

829 N Center Ave
Ste 210
Gaylord, MI 49735
Phone (989) 731-7860

825 N Center Ave
Gaylord, MI 49735
Phone (989) 731-2100

4100 Park Forest Dr
Ste 210
Traverse City, MI 49684
Phone (231) 935-5770

4100 Park Forest Dr
Traverse City, MI 49684
Phone (231) 392-8900

1105 Sixth St
Ste 103
Traverse City, MI 49684
Phone (231) 935-6455

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

1200 Sixth St
Ste 200
Traverse City, MI 49684

1400 Medical Campus Dr
Traverse City, MI 49684
Phone (231) 935-8000

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429142400000",
    "number": "1376756643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 PARK FOREST DR",
            "address_2": "SUITE 210",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847331",
            "telephone_number": "231-935-5770",
            "fax_number": "231-935-0747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 PARK FOREST DR",
            "address_2": "SUITE 210",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847331",
            "telephone_number": "231-935-5770",
            "fax_number": "231-935-0747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STODDARD",
        "first_name": "CATHERINE",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-07",
        "last_updated": "2015-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301093885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376756643",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.