Individual provider Active NPI

David S Sciamanna, DO

  • Neonatal-Perinatal Medicine Physician
  • Traverse City, MI
National Provider Identifier
1548268808
Registry record updated Nov 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
5101006999 Issued in MI
Practice address
1105 6TH St
Munson Medical Ctr-Nicu
Traverse City, MI 49684-2349
Phone
(231) 935-5544
NPI assigned
Jul 11, 2005
Last updated
Nov 16, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 5101006999 MI Primary

Addresses

Primary practice location

1105 6TH St
Munson Medical Ctr-Nicu
Traverse City, MI 49684-2349

Mailing address

1105 6TH St
Munson Medical Ctr-Nicu
Traverse City, MI 49684-2349
Phone (231) 935-5544

Other identifiers 5

IdentifierTypeStateIssuer
50027456OtherMIALLIANCE HEALTH
3552810144OtherMIBLUE CROSS
P64750OtherMIBLUE CARE NETWORK
4717354MedicaidMI
23561OtherMIPRIORITY HEALTH

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
I20161107002546 MI Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 0941589352

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321401600000",
    "number": "1548268808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 6TH ST",
            "address_2": "MUNSON MEDICAL CTR-NICU",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842349",
            "telephone_number": "231-935-5544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 6TH ST",
            "address_2": "MUNSON MEDICAL CTR-NICU",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842349",
            "telephone_number": "231-935-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCIAMANNA",
        "first_name": "DAVID",
        "middle_name": "S",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2011-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "MI",
            "license": "5101006999",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALLIANCE HEALTH",
            "identifier": "50027456",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "3552810144",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "P64750",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4717354",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIORITY HEALTH",
            "identifier": "23561",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.