NPIMap

Organization Active NPI

Munson Healthcare Manistee Hospital

  • General Acute Care Hospital
  • Manistee, MI
National Provider Identifier
1407949191
Registry record updated Apr 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
510020 Issued in MI
Legal business name
MUNSON HEALTHCARE MANISTEE HOSPITAL
Practice address
1465 E Parkdale Ave
Manistee, MI 49660-9785
Phone
(231) 398-1000
Fax
(231) 398-0364
NPI assigned
Oct 2, 2006
Last updated
Apr 20, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2026

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

Authorized official

Name
Peter Marinoff
Title
Pres/Ceo South Region
Phone
(231) 352-2285

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 133V00000X
Anesthesiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207L00000X
Emergency Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207P00000X
Medicare Defined Swing Bed Hospital Unit 275N00000X MI
General Acute Care Hospital 282N00000X 510020 MI Primary
Certified Registered Nurse AnesthetistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 367500000X

Addresses

Primary practice location

1465 E Parkdale Ave
Manistee, MI 49660-9785

Mailing address

1465 E Parkdale Ave
Manistee, MI 49660-9785
Phone (231) 398-1000

Other practice location 1

1345 E Parkdale Ave
Manistee, MI 49660-9318
Phone (231) 398-1750

Other practice location 2

1391 E Parkdale Ave
Manistee, MI 49660-9352
Phone (231) 398-1760

Other practice location 3

1293 E Parkdale Ave
Manistee, MI 49660-8904
Phone (231) 398-1710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040119000647 MI Part B Supplier - Clinic/Group Practice 3072414333 Receives reassigned benefits from 68 practitioners
4 other NPIs on this enrollment
Practice locations: Manistee, MI; Frankfort, MI; Cadillac, MI
O20131029000470 MI Part A Provider - Hospital 3072414333 Practice locations: Manistee, MI; Wellston, MI; Kaleva, MI; Bear Lake, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407949191. Details of each certification follow.

Hospital certification: CCN 230303

Legal name
MUNSON HEALTHCARE MANISTEE HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Dec 17, 2013
Last certification
Sep 20, 2013
Beds
25
Ownership / control type
Other
Organization structure
CorporationNon-profit
Enrollment address
1465 E Parkdale Ave
Manistee, MI 49660-9709
Other Hospital Practice Location
Hospital subgroups
Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Munson Healthcare Manistee HospitalCCN 230303 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Other
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

1391 E Parkdale Ave
Ste 101
Manistee, MI 49660
Phone (231) 398-1840

Ownership & related parties

All disclosed owners & managing parties 23

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Andrew Page Individual OtherTrustee Jan 1, 2024
Ruth Hoppe Individual OtherSecretary Jan 1, 2022
Paul Konopacki Individual Corporate OfficerCfo Jan 1, 2024
W-2 Managing EmployeeCfo Jan 1, 2024
Operational/Managerial ControlCfo Jan 1, 2024
Vincent Schultz Individual OtherTrustee Jan 1, 2024
Thomas Veryser Individual OtherTrustee Jan 1, 2022
Kenneth D Bloem Individual OtherVice Chair Jan 1, 2022
Timothy Nelson Individual Operational/Managerial ControlManaging Director Jan 1, 2013
OtherTreasure Jan 1, 2013
David Menegebier Individual OtherTrustee Jan 1, 2024
Edward Lanphier Individual Corporate DirectorBoard Member Jan 1, 2026
Kathy Dixon Individual OtherTrustee Jan 1, 2022
Mary Sanders Individual OtherTrustee Jan 1, 2022
Elaine Wood Individual OtherChair Jan 1, 2022
Claudia Rowland Individual Corporate DirectorBoard Member Jan 1, 2026
Munson Healthcare Organization, Traverse City, MI Corporation Operational/Managerial Control Apr 1, 2017 100%
Peter E Marinoff Individual Corporate OfficerPresident/Ceo South Region Jan 1, 2024
W-2 Managing EmployeePresident/Ceo South Region Jan 1, 2024
Operational/Managerial ControlPresident/Ceo South Region Jan 1, 2024
Edwin a Ness Individual Corporate DirectorCeo Apr 1, 2017
Owen Roberts Individual OtherTrustee Jan 1, 2022
Bruce Zenner Individual OtherTrustee Jan 1, 2022
Sakura Takano Individual OtherTrustee Jan 1, 2022
Kristine Thomas Individual OtherTrustee Jan 1, 2022
Brian Postma Individual Corporate DirectorTrustee Apr 1, 2017
Dino Recchia Individual OtherTrustee Jan 1, 2024
Jennifer King Individual OtherTrustee Jan 1, 2024

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 24

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 24

Practitioners & affiliated clinicians

Practitioners 69

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.

View all 69

Affiliated clinicians 172

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 172

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776643200000",
    "number": "1407949191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1465 E PARKDALE AVE",
            "city": "MANISTEE",
            "state": "MI",
            "postal_code": "496609785",
            "telephone_number": "231-398-1000",
            "fax_number": "231-398-0364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 E PARKDALE AVE",
            "city": "MANISTEE",
            "state": "MI",
            "postal_code": "496609785",
            "telephone_number": "231-398-1000",
            "fax_number": "231-398-0364"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1345 E Parkdale Ave",
            "address_purpose": "LOCATION",
            "city": "Manistee",
            "state": "MI",
            "postal_code": "496609318",
            "country_code": "US",
            "telephone_number": "231-398-1750",
            "fax_number": "231-398-1735",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1391 E Parkdale Ave",
            "address_purpose": "LOCATION",
            "city": "Manistee",
            "state": "MI",
            "postal_code": "496609352",
            "country_code": "US",
            "telephone_number": "231-398-1760",
            "fax_number": "231-398-1768",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1293 E Parkdale Ave",
            "address_purpose": "LOCATION",
            "city": "Manistee",
            "state": "MI",
            "postal_code": "496608904",
            "country_code": "US",
            "telephone_number": "231-398-1710",
            "fax_number": "231-398-1716",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MUNSON HEALTHCARE MANISTEE HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A",
        "authorized_official_last_name": "MARINOFF",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "PRES/CEO SOUTH REGION",
        "authorized_official_telephone_number": "231-352-2285"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "MI",
            "license": "510020",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manistee, MI

Sources for this page

Verify at the official NPI Registry.