NPIMap

Individual provider Active NPI

Benjamin Vanos, DO

  • Family Medicine Physician
  • Indian River, MI
National Provider Identifier
1508392614
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101023068 Issued in MI
Practice address
3860 S Straits Hwy
Indian River, MI 49749-5146
Phone
(231) 238-0581
NPI assigned
May 10, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101023068 MI Primary

Addresses

Primary practice location

3860 S Straits Hwy
Indian River, MI 49749-5146

Mailing address

1105 Sixth St
Traverse City, MI 49684-2345
Phone (231) 935-5000

Other practice location 1

829 N Center Ave Ste 210
Gaylord, MI 49735-1599
Phone (989) 731-7860

Other practice location 2

3040 Bourn St
Lewiston, MI 49756-8134
Phone (989) 786-4877

Other identifiers 1

IdentifierTypeStateIssuer
5101023068OtherMILICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200817000769 MI Practitioner - Family Practice 0941626337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3860 S Straits Hwy
MHC Omh Medical Group Indian River
Indian River, MI 49749-5146
Phone (231) 238-0581

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101023068MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Healthcare Otsego Memorial Hospital Current Accepting new patients
Munson Healthcare Otsego Memorial Hospital CurrentSince Aug 3, 2020 Accepting new patients
Munson Healthcare Otsego Memorial Hospital CurrentSince Aug 3, 2020 Accepting new patients
Munson Healthcare Otsego Memorial Hospital Current Accepting new patients
Munson Healthcare Otsego Memorial Hospital Current Accepting new patients
Munson Healthcare Otsego Memorial Hospital Current Accepting new patients
Munson Healthcare Otsego Memorial Hospital Current Accepting new patients

Locations

271 McCoy Rd W
Gaylord, MI 49735
Phone (989) 731-7708

829 N Center Ave
Gaylord, MI 49735
Phone (989) 731-2100

829 N Center Ave
Ste 210
Gaylord, MI 49735
Phone (989) 731-7860

3040 Bourn St
Lewiston, MI 49756
Phone (989) 731-7777

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

Interoperability endpoints

  • Direct secure messaging: bvanos@direct.mhc.net

Organizations & group practices 7

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 6

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": "1494374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1508392614",
    "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": "231-935-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3860 S STRAITS HWY",
            "city": "INDIAN RIVER",
            "state": "MI",
            "postal_code": "497495146",
            "telephone_number": "231-238-0581"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "829 N Center Ave Ste 210",
            "address_purpose": "LOCATION",
            "city": "Gaylord",
            "state": "MI",
            "postal_code": "497351599",
            "country_code": "US",
            "telephone_number": "989-731-7860",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3040 Bourn St",
            "address_purpose": "LOCATION",
            "city": "Lewiston",
            "state": "MI",
            "postal_code": "497568134",
            "country_code": "US",
            "telephone_number": "989-786-4877",
            "fax_number": "231-935-2004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANOS",
        "first_name": "BENJAMIN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-10",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101023068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "5101023068",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indian River, MI

Sources for this page

Verify at the official NPI Registry.