Andrew Wallace Freeborn, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

5601005642 Issued in MI

Practice address

1105 Sixth St
Traverse City, MI 49684-2345

Phone

(231) 935-7514

Fax

(231) 392-0039

NPI assigned

Sep 18, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Munson Medical CenterGroup PAC ID 3072426287, 377 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Munson Medical Center

  • Endocrinology, Diabetes & Metabolism Physician
  • Traverse City, MI
  • NPI 1083761860
  Medicare reassignment Care Compare group
• Munson Healthcare Cadillac

  • Rural Health Clinic/Center
  • MC Bain, MI
  • NPI 1336539063
  Medicare reassignment
• Munson Healthcare Grayling

  • Rural Health Clinic/Center
  • Roscommon, MI
  • NPI 1710383351
  Medicare reassignment
• Munson Healthcare Manistee Hospital

  • General Acute Care Hospital
  • Manistee, MI
  • NPI 1407949191
  Medicare reassignment
• Munson Healthcare Cadillac

  • Psychiatry Physician
  • Traverse City, MI
  • NPI 1720955081
  NPD
• Munson Healthcare Cadillac

  • Rural Health Clinic/Center
  • Cadillac, MI
  • NPI 1912303728
  NPD
• Munson Healthcare Grayling

  • Rural Health Clinic/Center
  • Grayling, MI
  • NPI 1891191698
  NPD
• Munson Healthcare Manistee Hospital

  • Surgery Physician
  • Manistee, MI
  • NPI 1861577389
  NPD
• Munson Medical Center

  • Internal Medicine Physician
  • Traverse City, MI
  • NPI 1205864220
  NPD
• Munson Medical Center

  • Psychiatric Hospital Unit
  • Traverse City, MI
  • NPI 1891586103
  NPD
• Munson Healthcare Cadillac

  • Urology Physician
  • Cadillac, MI
  • NPI 1932726577
  NPD (past)
• Munson Healthcare Grayling

  • Rural Health Clinic/Center
  • Prudenville, MI
  • NPI 1144626052
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Munson Medical Center

  • General Acute Care Hospital
  • Traverse City, MI
  • NPI 1952307852
  Care Compare affiliation

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

{
    "created_epoch": "1253232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1508190851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 SIXTH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842345",
            "telephone_number": "231-935-7514",
            "fax_number": "231-392-0039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 SIXTH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842345",
            "telephone_number": "231-935-7514",
            "fax_number": "231-392-0039"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4045 W Royal Dr",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496848965",
            "country_code": "US",
            "telephone_number": "231-935-0900",
            "fax_number": "231-935-0308",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1221 Sixth St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496842359",
            "country_code": "US",
            "telephone_number": "231-392-8400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "217 S Madison St",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496842321",
            "country_code": "US",
            "telephone_number": "231-392-8400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3537 W Front St",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496847941",
            "country_code": "US",
            "telephone_number": "231-935-5880",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1221 Sixth St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496842360",
            "country_code": "US",
            "telephone_number": "231-935-0322",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8872 Professional Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Cadillac",
            "state": "MI",
            "postal_code": "496018482",
            "country_code": "US",
            "telephone_number": "231-779-0320",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1345 E Parkdale Ave",
            "address_purpose": "LOCATION",
            "city": "Manistee",
            "state": "MI",
            "postal_code": "496609318",
            "country_code": "US",
            "telephone_number": "231-398-1750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FREEBORN",
        "first_name": "ANDREW",
        "middle_name": "WALLACE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-18",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MI",
            "license": "5601005642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura E Franseen, M.D.
• Lisa L Franseen, PHD
• Gretchen Gaylord Fraser, OTR, CLT-LANA
• Tobin J Fraser, DO
• Joseph Frazee
• Kacie Ann Freeborn, P.A.
• Thomas Freeman Jr., MD
• James Robert Frew Jr., MD
• Andrea Marie Frey, PA-C
• Ryan Richard Freye, PHARM.D.

• Surgical Physician Assistant in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Surgical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.