Individual provider Active NPI

Patrick Thomas Gartland, M.D.

  • Diagnostic Radiology Physician
  • Traverse City, MI
National Provider Identifier
1649329426
Registry record updated Apr 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
4301088533 Issued in MI
Practice address
1105 Sixth St
Traverse City, MI 49684-2345
Phone
(231) 935-0497
NPI assigned
Jan 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 4301088533 MI Primary

Addresses

Primary practice location

1105 Sixth St
Traverse City, MI 49684-2345

Mailing address

PO Box 30516, Dept. 9516
Lansing, MI 48909-8016
Phone (231) 935-0497

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
I20120827000207 MI Practitioner - Diagnostic Radiology 1153599329 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Medical College of Wisconsin, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grand Traverse Radiologists PCGroup PAC ID 6002866407, 32 clinicians

Practice addresses (Care Compare)

1105 6TH St
Traverse City, MI 49684-2345
Phone (231) 935-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.64 of 100Reported as group
Quality
91.34
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301088533MIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Richard Burke Pain and Neuromodulation PLLC CurrentSince Aug 11, 2023 Accepting new patients
Grand Traverse Radiologists PC Diagnostic Radiology CurrentSince Jul 1, 2012 Accepting new patients
Novello Imaging PLC CurrentSince Jan 1, 2021 Accepting new patients

Locations

14700 Lake Shore Dr
Charlevoix, MI 49720
Phone (231) 547-3840

4290 Copper Ridge Dr
Ste 100
Traverse City, MI 49684
Phone (231) 421-8505

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

3769 Columbus Pike
Ste 220
Delaware, OH 43015

Organizations & group practices 3

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.

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": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588118400000",
    "number": "1649329426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30516, DEPT. 9516",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489098016",
            "telephone_number": "231-935-0497",
            "fax_number": "423-826-1286"
        },
        {
            "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": "231-935-0497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARTLAND",
        "first_name": "PATRICK",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301088533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.