Matthew William Lederer, DO
Individual provider Active NPI Family Medicine Physician · Clinton TWP, MI
NPI 1417523481 · NPPES record last updated Aug 20, 2024
Key facts
- NPI
- 1417523481
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 5101028234 (MI)
- Practice address
- 15855 19 Mile Rd
Clinton TWP, MI 48038-3504 - Phone
- (586) 263-2300
- NPI assigned
- Jun 1, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 8
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Michigan State University College of Osteopathic Medicine, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Munson Medical Group
Great Lakes Therapy Housecalls PC
Practice addresses (Care Compare)
5041 N Royal Dr
Traverse City, MI 49684-6986
Phone (231) 935-0600
9731 E Cherry Bend Rd
Traverse City, MI 49684-7621
Phone (231) 941-8100
Hospital & facility affiliations
- Munson Home Care
- Hospice of Mecosta County
- Munson Medical Center
- Paul Oliver Memorial Hospital
- Munson Healthcare Cadillac Hospital
- Kalkaska Memorial Health Center
- Charlevoix Area Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 85.92
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240828000882 | MI | Practitioner - Family Practice | 2264833607 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Munson Medical Group | Current |
Accepting new patients | |
| Munson Medical Group | Current | Accepting new patients | |
| Munson Medical Center | Family Medicine | Past | Accepting new patients |
Locations
2891 Momentum Pl
Chicago, IL 60689
5041 N Royal Dr
Traverse City, MI 49684
Phone (231) 392-8400
1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000
1200 Sixth St
Ste 200
Traverse City, MI 49684
Interoperability endpoints
- mlederer677796@direct.hfhs.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Medicine Physician | 207Q00000X | 5101028234 | MI | Yes |
Addresses
Primary practice location
15855 19 Mile Rd
Clinton TWP, MI 48038-3504
Mailing address
46300 White Cap Dr
Macomb, MI 48044-5731
Phone (586) 850-0137
Other practice location 1
5041 N Royal Dr
Traverse City, MI 49684-6986
Phone (231) 935-0600
Other providers in Clinton TWP, MI
- Lawrence Lawson
- Christopher Minh Tan Le
- Leandro F Africa, MD, PC
- Ariel Leavitt
- Steven Lechner
- Angela Lee
- Angela Lee
- Gab Soon Lee
- Megan Jinmoon Lee
- Brenda J Lehman
All providers in Clinton TWP, MI · Family Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 20, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.