Northwest Michigan Surgical Group, P.C.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

JM008369 Issued in MI

Legal business name

NORTHWEST MICHIGAN SURGICAL GROUP, P.C.

Practice address

872 Munson Ave Ste C
Traverse City, MI 49686-3638

Phone

(231) 935-8346

Fax

(231) 935-2850

NPI assigned

Jul 30, 2006

Last updated

Jul 25, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. James R. McDonnell, D.O.NPI 1073517587

Title

President/Owner

Phone

(231) 935-8346

Specialties & licenses 3

Addresses

Other names 1

• Professional Corporation Other name

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 7

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.

• James R McDonnell, D.O.

  • Surgery Physician
  • Traverse City, MI
  • NPI 1073517587
  Medicare reassignment NPD Authorized official
• Terri L Glenn, NP

  • Family Nurse Practitioner
  • Acme, MI
  • NPI 1548398597
  NPD
• David J Amalfitano, D.O.

  • Vascular Surgery Physician
  • Traverse City, MI
  • NPI 1386646636
  NPD (past)
• Carl B Anders, MD

  • Internal Medicine Physician
  • Traverse City, MI
  • NPI 1194779843
  NPD (past)
• Michael D Colburn

  • Vascular Surgery Physician
  • Traverse City, MI
  • NPI 1760486260
  NPD (past)
• Robert M Dotterrer, MD

  • Surgery Physician
  • Traverse City, MI
  • NPI 1962403717
  NPD (past)
• Ann K Kuenker, D.O.

  • Family Medicine Physician
  • Traverse City, MI
  • NPI 1609870104
  NPD (past)

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753401600000",
    "number": "1386659043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "872 MUNSON AVE STE C",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863638",
            "telephone_number": "231-935-8346",
            "fax_number": "231-935-2850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "872 MUNSON AVE STE C",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863638",
            "telephone_number": "231-935-8346",
            "fax_number": "231-935-2850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST MICHIGAN SURGICAL GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-24",
        "status": "A",
        "authorized_official_last_name": "MCDONNELL",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "231-935-8346",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "MI",
            "license": "JM008369",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Professional Corporation",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Northwest Michigan Health Services, Inc
• Northwest Michigan Health Services, Inc.
• Northwest Michigan Health Services, Inc.
• Northwest Michigan Heart & Vascular Specialists
• Northwest Michigan Surgery Center LLC (Copper Ridge Surgery Center)
• Northwest Senior Resources Incorporated (Area Agency on Aging of Northwest Michigan)
• Northwestern Michigan College (Northwestern Michigan College Student Health Services)
• Northwestern Michigan Dermatology
• Northwestern Michigan Dermatology PC
• Northwestern Michigan Emergency Physicians PC

• Surgery Physician in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2025; 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.