Active NPI
Emily Rachelle McMullen-Tabry, MD
- Anatomic Pathology & Clinical Pathology Physician
- Traverse City, MI
National Provider Identifier
1629422407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 4301501461
- Practice address
- 1105 Sixth St
Traverse City, MI 49684-2345 - Phone
- (231) 935-6100
- NPI assigned
- Apr 19, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 4301501461 | MI | Primary |
Addresses
Primary practice location
1105 Sixth St
Traverse City, MI 49684-2345
Mailing address
1105 Sixth St
Traverse City, MI 49684-2345
Other practice location 1
400 Hobart St
Cadillac, MI 49601-2331
Phone (231) 876-7200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629422407 | Medicaid | MI |
Other names 1
- Emily R McMullen
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pathology
- Education
- University of Iowa, RJ & L Carver College of Medicine, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1105 6TH St
Traverse City, MI 49684-2345
Phone (231) 935-6100
Hospital & facility affiliations
- Munson Medical Center
- Munson Healthcare Cadillac Hospital
- Munson Healthcare Grayling Hospital
- Charlevoix Area Hospital
- Munson Healthcare Otsego Memorial Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 94.14 of 100
- Quality
- 88.27
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301501461 | MI | MD | Anatomic Pathology & Clinical Pathology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grand Traverse Pathology, PLLC | Anatomic Pathology & Clinical Pathology | Current | Accepting new patients |
Locations
400 Hobart St
Cadillac, MI 49601
Phone (231) 876-7200
1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000
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 and National Provider Directory roles.
-
- Anatomic Pathology & Clinical Pathology Physician
- Traverse City, MI
- NPI 1306868427
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Cadillac, MI
- NPI 1841696754
-
- Critical Access Hospital
- Charlevoix, MI
- NPI 1346260692
-
- Rural Acute Care Hospital
- Grayling, MI
- NPI 1083010953
-
- General Acute Care Hospital
- Gaylord, MI
- NPI 1124028972
-
- General Acute Care Hospital
- Traverse City, MI
- NPI 1952307852
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1461024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782864000000",
"number": "1629422407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1105 SIXTH ST",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496842345"
},
{
"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": "231-935-6100"
}
],
"practiceLocations": [
{
"address_1": "400 Hobart St",
"address_purpose": "LOCATION",
"city": "Cadillac",
"state": "MI",
"postal_code": "496012331",
"country_code": "US",
"telephone_number": "231-876-7200",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCMULLEN-TABRY",
"first_name": "EMILY",
"middle_name": "RACHELLE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-19",
"last_updated": "2026-07-01",
"certification_date": "2026-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "MI",
"license": "4301501461",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1629422407",
"state": "MI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "EMILY",
"last_name": "MCMULLEN",
"middle_name": "R",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2026; 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.