Individual provider Active NPI

Garrick R. Cvitkovich, MD

  • Surgery Physician
  • Grayling, MI
National Provider Identifier
1659316784
Registry record updated Nov 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
4301075768 Issued in MI
Practice address
1250 Michigan Ave
Grayling, MI 49738-7038
Phone
(989) 348-0880
Fax
(989) 348-0881
NPI assigned
Jun 20, 2006
Last updated
Nov 23, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 4301075768 MI Primary

Addresses

Primary practice location

1250 Michigan Ave
Grayling, MI 49738-7038

Mailing address

1250 E Michigan Ave
Grayling, MI 49738-7074
Phone (989) 348-1040

Other identifiers 1

IdentifierTypeStateIssuer
4872182MedicaidMI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gcvitkovich@direct.mhc.net

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
I20060620000205 MI Practitioner - General Surgery 4981616653 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Indiana University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Munson Healthcare GraylingGroup PAC ID 2062736655, 64 clinicians
Kalkaska Memorial Health CenterGroup PAC ID 3577536002, 57 clinicians

Practice addresses (Care Compare)

1010 W N Down River Rd
Munson Healthcare Grayling Physician Networ
Grayling, MI 49738-2060
Phone (231) 876-7476

419 S Coral St
Kalkaska, MI 49646-2503
Phone (231) 258-7500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy95
Hernia repair - groin (open)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux53

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kalkaska Memorial Health Center Surgery CurrentSince Jun 1, 2021 Accepting new patients
Munson Healthcare Grayling CurrentSince Dec 1, 2015 Accepting new patients
Kalkaska Memorial Health Center CurrentSince Jun 1, 2021 Accepting new patients
Munson Healthcare Grayling Surgery Current Accepting new patients
Munson Healthcare Grayling Current Accepting new patients
Munson Healthcare Grayling CurrentSince Dec 1, 2015 Accepting new patients
Munson Healthcare Grayling Past Accepting new patients
Mercy Hospital Grayling Past Accepting new patients
Mercy Professional Services Past Accepting new patients

Locations

3781 Momentum Pl
Chicago, IL 60689

1010 W North Down River Rd
Grayling, MI 49738
Phone (989) 348-0800

1100 E Michigan Ave
Grayling, MI 49738
Phone (989) 348-0317

1250 E Michigan Ave
Grayling, MI 49738
Phone (989) 348-0550

809 E Michigan Ave
Grayling, MI 49738
Phone (989) 348-0530

419 S Coral St
Kalkaska, MI 49646
Phone (231) 258-7500

2585 W Houghton Lake Dr
Prudenville, MI 48651
Phone (989) 348-0055

234 Lake St
Roscommon, MI 48653
Phone (517) 275-1200

Interoperability endpoints

  • Direct secure messaging: gcvitkovich@direct.mhc.net

Organizations & group practices 9

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 3

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": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606089600000",
    "number": "1659316784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 E MICHIGAN AVE",
            "city": "GRAYLING",
            "state": "MI",
            "postal_code": "497387074",
            "telephone_number": "989-348-1040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 MICHIGAN AVE",
            "city": "GRAYLING",
            "state": "MI",
            "postal_code": "497387038",
            "telephone_number": "989-348-0880",
            "fax_number": "989-348-0881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CVITKOVICH",
        "first_name": "GARRICK",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301075768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4872182",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gcvitkovich@direct.mhc.net",
            "affiliation": "N",
            "address_1": "1250 Michigan Ave",
            "city": "Grayling",
            "state": "MI",
            "country_code": "US",
            "postal_code": "497387038",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grayling, MI

Sources for this page

Verify at the official NPI Registry.