Individual provider Active NPI

Christine L Ceglarek

  • Nurse Practitioner
  • Petoskey, MI
National Provider Identifier
1487226924
Registry record updated Jul 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704230547 Issued in MI
Practice address
560 W Mitchell St Ste 400
Petoskey, MI 49770-2274
Phone
(231) 330-3585
Fax
(231) 487-4001
NPI assigned
Jul 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704230547 MI Primary

Addresses

Primary practice location

560 W Mitchell St Ste 400
Petoskey, MI 49770-2274

Mailing address

560 W Mitchell St Ste 400
Petoskey, MI 49770-2274
Phone (231) 330-3585

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210818004105 MI Practitioner - Nurse Practitioner 8022413764 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren Northern MichiganGroup PAC ID 9931018181, 60 clinicians

Practice addresses (Care Compare)

416 Connable Ave
Petoskey, MI 49770-2212
Phone (231) 487-4000

Hospital & facility affiliations

  • McLaren Northern Michigan Hospital, Petoskey, MI, CCN 230105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704230547MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Central Michigan CurrentSince Sep 26, 2021 Accepting new patients
McLaren Central Michigan Current Accepting new patients
McLaren Central Michigan CurrentSince Sep 26, 2021 Accepting new patients
McLaren Northern Michigan CurrentSince Jun 7, 2023 Accepting new patients
McLaren Northern Michigan CurrentSince Jun 7, 2023 Accepting new patients
McLaren Central Michigan Past Accepting new patients

Locations

14676 W Upright St
Charlevoix, MI 49720
Phone (231) 487-5447

1221 South Dr
Mt Pleasant, MI 48858
Phone (989) 772-6700

2390 Mitchell Park Dr
Ste D
Petoskey, MI 49770
Phone (231) 242-1760

560 W Mitchell St
Ste 400
Petoskey, MI 49770
Phone (231) 330-3585

416 Connable Ave
Petoskey, MI 49770
Phone (231) 487-4000

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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": "1626220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1487226924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 W MITCHELL ST STE 400",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702274",
            "telephone_number": "231-330-3585",
            "fax_number": "231-487-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 W MITCHELL ST STE 400",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702274",
            "telephone_number": "231-330-3585",
            "fax_number": "231-487-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CEGLAREK",
        "first_name": "CHRISTINE",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-14",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704230547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petoskey, MI

Sources for this page

Verify at the official NPI Registry.