Individual provider Active NPI

Jacob Donald Ramseyer

  • Emergency Medicine Physician
  • Traverse City, MI
National Provider Identifier
1518320910
Registry record updated Jun 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
5101024397 Issued in MI
Practice address
1105 Sixth St
Traverse City, MI 49684-2345
Phone
(231) 947-0673
Fax
(801) 740-2847
NPI assigned
Apr 1, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 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
Emergency Medicine Physician 207P00000X 5101024397 MI Primary

Addresses

Primary practice location

1105 Sixth St
Traverse City, MI 49684-2345

Mailing address

4624 N Spider Lake Rd
Traverse City, MI 49696-8440
Phone (231) 947-0673

Other practice location 1

419 S Coral St
Kalkaska, MI 49646-2503
Phone (231) 258-7506

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
I20190805002196 MI Practitioner - Emergency Medicine 3577800846 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hawk Emergency Group, P.C.Group PAC ID 6800241050, 55 clinicians
Interlochen Emergency Group PCGroup PAC ID 3577918606, 49 clinicians

Practice addresses (Care Compare)

14700 Lake Shore Dr
Charlevoix, MI 49720-1931
Phone (231) 547-4024

224 Park Ave
Frankfort, MI 49635-9658
Phone (231) 352-2200

Hospital & facility affiliations

  • Charlevoix Area Hospital Hospital, Charlevoix, MI, CCN 231322
  • Munson Healthcare Otsego Memorial Hospital Hospital, Gaylord, MI, CCN 230133
  • Paul Oliver Memorial Hospital Hospital, Frankfort, MI, CCN 231300
  • Munson Medical Center Hospital, Traverse City, MI, CCN 230097

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101024397MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Interlochen Emergency Group, P.C. Emergency Medicine CurrentSince Dec 10, 2023 Accepting new patients
Hawk Emergency Group, P.C. Emergency Medicine CurrentSince Dec 10, 2023 Accepting new patients
Caberfae Emergency Group, P.C. Emergency Medicine CurrentSince Dec 10, 2023 Accepting new patients
Northwestern Michigan Emergency Physicians PC Emergency Medicine CurrentSince Jul 1, 2019 Accepting new patients
Traverse Observation Physician Services PC Emergency Medicine PastSince Jun 5, 2022 Accepting new patients

Locations

400 Hobart St
Cadillac, MI 49601
Phone (231) 876-7200

14700 Lake Shore Dr
Charlevoix, MI 49720
Phone (231) 547-3840

224 Park Ave
Frankfort, MI 49635
Phone (231) 352-2200

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

1465 E Parkdale Ave
Manistee, MI 49660
Phone (231) 398-1000

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

Organizations & group practices 5

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 4

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": "1459468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656288000000",
    "number": "1518320910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4624 N SPIDER LAKE RD",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496968440",
            "telephone_number": "231-947-0673",
            "fax_number": "801-740-2847"
        },
        {
            "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": "231-947-0673",
            "fax_number": "801-740-2847"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "419 S Coral St",
            "address_purpose": "LOCATION",
            "city": "Kalkaska",
            "state": "MI",
            "postal_code": "496462503",
            "country_code": "US",
            "telephone_number": "231-258-7506",
            "fax_number": "231-258-7592",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAMSEYER",
        "first_name": "JACOB",
        "middle_name": "DONALD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-01",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101024397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.