Mitchell S Stuck, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101015688 Issued in MI

Practice address

5191 Rosewood Dr
Traverse City, MI 49685-9137

Phone

(231) 946-1979

Fax

(231) 946-1984

NPI assigned

Nov 2, 2006

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

Electronic endpoints 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mstuck105117@direct.covenanthealthcare.com

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.

• Mary Free Bed Rehabilitation Hospital

  • Rehabilitation Hospital
  • Grand Rapids, MI
  • NPI 1730133463
  Medicare reassignment NPD
• Mary Free Bed Rehabilitation Hospital

  • Physical Medicine & Rehabilitation Physician
  • Grand Rapids, MI
  • NPI 1053641589
  NPD

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1609954833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 WEALTHY ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495035247",
            "telephone_number": "616-840-8000",
            "fax_number": "616-840-9642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5191 ROSEWOOD DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496859137",
            "telephone_number": "231-946-1979",
            "fax_number": "231-946-1984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUCK",
        "first_name": "MITCHELL",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101015688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mstuck105117@direct.covenanthealthcare.com",
            "affiliation": "N",
            "address_1": "5191 Rosewood Dr",
            "city": "Traverse City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "496859137",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Katie J Strittmatter, FNP
• Susan J Stroebe, RN, MS
• Karlyn Stroope, PT, DPT
• Jordan Mitchell Struble
• Structure and Function Chiropractic and Rehab PLC
• Janice Carole Stump, MSW
• Michelle Sturdevant, OT
• Jeffrey Edward Stych, D.P.M.
• William Corry Stych, D.P.M.
• Mark R Suitor, R.PH.

• Family Medicine Physician in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.