Individual provider Active NPI

Lara Madigan, D.O.

  • Family Medicine Physician
  • Traverse City, MI
National Provider Identifier
1548297765
Registry record updated Jan 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101015720 Issued in MI
Practice address
10223 E Cherry Bend Rd
Traverse City, MI 49684-7304
Phone
(231) 929-7933
NPI assigned
Jun 26, 2006
Last updated
Jan 26, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2011

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 5101015720 MI Primary

Addresses

Primary practice location

10223 E Cherry Bend Rd
Traverse City, MI 49684-7304

Mailing address

10223 E Cherry Bend Rd
Traverse City, MI 49684-7304
Phone (231) 929-7933

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
I20061004000168 MI Practitioner - Family Practice 4486659075 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thirlby Clinic PLCGroup PAC ID 3274588116, 12 clinicians
Great Lakes Therapy Housecalls PCGroup PAC ID 7719876580, shared by 2 NPIs, 71 clinicians

Practice addresses (Care Compare)

4110 Copper Ridge Dr
Suite 100
Traverse City, MI 49684-6721
Phone (231) 935-8950

9731 E Cherry Bend Rd
Traverse City, MI 49684-7621
Phone (231) 941-8100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101015720MIMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: lara.madigan@tbcl.eclinicaldirectplus.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296000000000",
    "number": "1548297765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10223 E CHERRY BEND RD",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847304",
            "telephone_number": "231-929-7933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10223 E CHERRY BEND RD",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847304",
            "telephone_number": "231-929-7933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADIGAN",
        "first_name": "LARA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-26",
        "last_updated": "2011-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101015720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.