Individual provider Active NPI

Olivia Juntila, MD

  • Anesthesiology Physician
  • Traverse City, MI
National Provider Identifier
1497275929
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
4301504547 Issued in MI
Practice address
1105 6TH St
Traverse City, MI 49684-2345
Phone
(231) 935-5000
NPI assigned
Jun 26, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MI
Anesthesiology Physician 207L00000X 4301504547 MI Primary

Addresses

Primary practice location

1105 6TH St
Traverse City, MI 49684-2345

Mailing address

4100 Park Forest Dr Ste 210
Traverse City, MI 49684-7306
Phone (231) 935-5770

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210712001872 MI Practitioner - Anesthesiology 5991075228 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Michigan Medical School, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Munson Medical Group 191 clinicians
Munson Medical Center 377 clinicians

Practice addresses (Care Compare)

1200 6TH St
Traverse City, MI 49684-2369
Phone (231) 935-5800

4100 Park Forest Dr
Traverse City, MI 49684-7331
Phone (231) 392-8900

Hospital & facility affiliations

  • Munson Medical Center Hospital, Traverse City, MI, CCN 230097

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Medical Group CurrentSince Sep 16, 2022 Accepting new patients
Munson Medical Center CurrentSince Feb 1, 2025 Accepting new patients
Munson Medical Group Anesthesiology CurrentSince Sep 16, 2022 Accepting new patients
Munson Medical Center Anesthesiology CurrentSince Feb 1, 2025 Accepting new patients
Munson Medical Group Current Accepting new patients

Locations

2891 Momentum Pl
Chicago, IL 60689

4100 Park Forest Dr
Traverse City, MI 49684
Phone (231) 392-8900

4100 Park Forest Dr
Ste 210
Traverse City, MI 49684
Phone (231) 935-5770

1105 Sixth St
Ste 103
Traverse City, MI 49684
Phone (231) 935-6455

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

1200 Sixth St
Ste 200
Traverse City, MI 49684

Organizations & group practices 17

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.

View all 17

Hospital & facility affiliations 1

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": "1498435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1497275929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 PARK FOREST DR STE 210",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847306",
            "telephone_number": "231-935-5770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 6TH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842345",
            "telephone_number": "231-935-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNTILA",
        "first_name": "OLIVIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-26",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301504547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.