Individual provider Active NPI

Michael J Samalik, MD

  • Family Medicine Physician
  • Gaylord, MI
National Provider Identifier
1508832098
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301406335 Issued in MI
Practice address
1320 E M 32
Gaylord, MI 49735-8378
Phone
(989) 731-5092
Fax
(989) 731-7639
NPI assigned
Feb 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 4301406335 MI Primary

Addresses

Primary practice location

1320 E M 32
Gaylord, MI 49735-8378

Mailing address

PO Box 2219
Gaylord, MI 49734-2219
Phone (989) 731-5092

Other identifiers 1

IdentifierTypeStateIssuer
0806900341OtherMIBLUE CROSS BLUE SHIELD

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
I20100430000649 MI Practitioner - Family Practice 8921135559

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301406335MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Memorial Joint Operating Company Past Accepting new patients
Gaylord Family Practice Associates PLC Family Medicine Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1508832098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2219",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497342219",
            "telephone_number": "989-731-5092",
            "fax_number": "989-731-7639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 E M 32",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497358378",
            "telephone_number": "989-731-5092",
            "fax_number": "989-731-7639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMALIK",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301406335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0806900341",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaylord, MI

Sources for this page

Verify at the official NPI Registry.