Justin Tannir, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

4301092763 Issued in MI

Practice address

5199 N Royal Dr
Traverse City, MI 49684-9201

Phone

(231) 935-8101

Fax

(231) 346-5926

NPI assigned

Jan 30, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Ophthalmology

Education

Northwestern University Feinberg Medical School, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Traverse City Ophthalmology PLLCGroup PAC ID 6608273412, 10 clinicians

University Physician GroupGroup PAC ID 8628087681, 399 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kalkaska Memorial Health Center Hospital, Kalkaska, MI, CCN 231301
• Munson Medical Center Hospital, Traverse City, MI, CCN 230097

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Traverse City Ophthalmology PLLC

  • Ophthalmology Physician
  • Traverse City, MI
  • NPI 1225616279
  Medicare reassignment Care Compare group NPD
• University Physician Group

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1447299797

  Ophthalmology

  Medicare reassignment Care Compare group NPD
• University Physician Group

  • Speech-Language Pathologist
  • Detroit, MI
  • NPI 1336417146
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Kalkaska Memorial Health Center

  • Critical Access Hospital
  • Kalkaska, MI
  • NPI 1497751309
  Care Compare affiliation
• Munson Medical Center

  • General Acute Care Hospital
  • Traverse City, MI
  • NPI 1952307852
  Care Compare affiliation

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

{
    "created_epoch": "1201651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590624000000",
    "number": "1578740668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 E. MAPLE RD.",
            "address_2": "SUITE 400-CREDENTIALING",
            "city": "TROY",
            "state": "MI",
            "postal_code": "48083",
            "telephone_number": "313-577-8900",
            "fax_number": "313-577-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5199 N ROYAL DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496849201",
            "telephone_number": "231-935-8101",
            "fax_number": "231-346-5926"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "419 S Coral St",
            "address_purpose": "LOCATION",
            "city": "Kalkaska",
            "state": "MI",
            "postal_code": "496462503",
            "country_code": "US",
            "telephone_number": "231-258-7695",
            "fax_number": "231-258-3171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANNIR",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-30",
        "last_updated": "2020-05-28",
        "certification_date": "2020-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "4301092763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "4301092763",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James L Talbott, MS LLP
• Zoe Elizabeth Tambs
• Renee Michelle Tamlyn, D.O.
• Tamlynn L. Evans, PLC
• Daniel Scott Tanis Jr., PTA
• Leah Ann Tatasciore, RN PHCNS-BC CBIS
• Tawfiq Alkilani DDS PLLC
• Anne P Taylor, M.D.
• Jeremy Taylor, ATC
• Nathan A Taylor

• Ophthalmology Physician in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Ophthalmology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.