Organization Active NPI

Dr Justin J Hollander PC

  • Orthopaedic Surgery Physician
  • Traverse City, MI
National Provider Identifier
1396030037
Registry record updated Jun 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
5101016797 Issued in MI
Legal business name
DR JUSTIN J HOLLANDER PC
Practice address
5246 N Royal Dr
Traverse City, MI 49684-6984
Phone
(231) 935-0957
Fax
(231) 935-0960
NPI assigned
Jun 10, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2011

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

Authorized official

Name
Dr. Justin Joseph Hollander, D.O.NPI 1053538868
Title
Physician
Phone
(231) 935-0957

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X 5101016797 MI Primary

Addresses

Primary practice location

5246 N Royal Dr
Traverse City, MI 49684-6984

Mailing address

5246 N Royal Dr
Traverse City, MI 49684-6984
Phone (231) 935-0957

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110815000528 MI Part B Supplier - Clinic/Group Practice 0244409928 Receives reassigned benefits from 2 practitioners
Practice locations: Traverse City, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1307664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307664000000",
    "number": "1396030037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5246 N ROYAL DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496846984",
            "telephone_number": "231-935-0957",
            "fax_number": "231-935-0960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5246 N ROYAL DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496846984",
            "telephone_number": "231-935-0957",
            "fax_number": "231-935-0960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR JUSTIN J HOLLANDER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-10",
        "last_updated": "2011-06-10",
        "status": "A",
        "authorized_official_last_name": "HOLLANDER",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "231-935-0957",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "5101016797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jun 10, 2011; 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.