Ausable Medical Associates, PC
Organization Active NPI Family Nurse Practitioner · Grayling, MI
NPI 1689697930 · NPPES record last updated Jan 27, 2014
Key facts
- NPI
- 1689697930
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 4704159028 (MI)
- Legal business name
- AUSABLE MEDICAL ASSOCIATES, PC
- Practice address
- 81 S. I-75 Business Loop
Grayling, MI 49738-0393 - Phone
- (989) 348-7400
- Fax
- (888) 821-5005
- NPI assigned
- Jul 26, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Gerald W Gertiser II, MSN, FNP-BC
- Title
- President
- Phone
- (989) 348-7400
Practitioners 9
-
Amanda G Blades, FNP-BC
-
Brigid Deleo, FNP-C
-
Noel Lynn Deshano, FNP
-
William B. Holscher, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031201000518 | MI | Part B Supplier - Clinic/Group Practice | 3173428422 |
Receives reassigned benefits from 8 practitioners Practice locations: Grayling, MI |
National Provider Directory
Locations
81 S I 75 Business Loop
Grayling, MI 49738
Phone (989) 348-3128
1200 W North Down River Rd
Grayling, MI 49738
Phone (517) 348-2896
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | LH010698 | MI | |
| Medical Physician Assistant |
363AM0700X | 5601002890 | MI | |
| Family Nurse Practitioner |
363LF0000X | 4704159028 | MI | Yes |
| Family Nurse Practitioner |
363LF0000X | 4704216377 | MI |
Addresses
Primary practice location
81 S. I-75 Business Loop
Grayling, MI 49738-0393
Mailing address
PO Box 393
Grayling, MI 49738-0393
Phone (989) 348-7400
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 104563113 | Medicaid | MI | |
| 080B010120 | Other | MI | MD'S & DO'S BCBS GRP # |
| 500B010130 | Other | MI | NP'S BCBS GROUP # |
Other names
- AuSable Urgent Care PC
Other providers in Grayling, MI
- Apria Healthcare LLC
- Atrium Grayling LLC
- Robert A Aubry
- Ausable Family Dental
- Ausable Free Clinic
- Ausable Primary Care PC
- Ausable Urology, P.C.
- Robert Louis Balestrero
- Jewell Barnard
- Baruch SLS, Inc.
All providers in Grayling, MI · Family Nurse Practitioner in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 27, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.