NPIMap

Individual provider Active NPI

Joseph Avery Rexroat, M.D.

  • Family Medicine Physician
  • Traverse City, MI
National Provider Identifier
1699126102
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301117095 Issued in MI
Practice address
921 W Front St
Traverse City, MI 49684-2327
Phone
(231) 252-0068
Fax
(231) 213-8729
NPI assigned
Jun 27, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301117095 MI Primary

Addresses

Primary practice location

921 W Front St
Traverse City, MI 49684-2327

Mailing address

1105 Sixth St
Traverse City, MI 49684-2345
Phone (231) 252-0068

Other practice location 1

230 W Oak St
Fremont, MI 49412-1526
Phone (231) 924-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190727000139 MI Practitioner - Family Practice 6103114335 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Human Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Munson Medical GroupGroup PAC ID 8820277015, 191 clinicians

Practice addresses (Care Compare)

224 Circle Dr
Traverse City, MI 49684-2700
Phone (231) 932-4912

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301117095MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Medical Group CurrentSince Sep 22, 2023 Accepting new patients
Munson Medical Group Current Accepting new patients
Munson Medical Group CurrentSince Sep 22, 2023 Accepting new patients
Munson Medical Center Family Medicine Past Accepting new patients
Newaygo County General Hospital Association Past Accepting new patients

Locations

2891 Momentum Pl
Chicago, IL 60689

921 W Front St
Traverse City, MI 49684
Phone (231) 252-0068

224 Circle Dr
Traverse City, MI 49684
Phone (231) 932-4912

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

1200 Sixth St
Ste 200
Traverse City, MI 49684

Organizations & group practices 5

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 7

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": "1466985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1699126102",
    "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",
            "telephone_number": "231-252-0068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 W FRONT ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842327",
            "telephone_number": "231-252-0068",
            "fax_number": "231-213-8729"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "230 W Oak St",
            "address_purpose": "LOCATION",
            "city": "Fremont",
            "state": "MI",
            "postal_code": "494121526",
            "country_code": "US",
            "telephone_number": "231-924-4200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REXROAT",
        "first_name": "JOSEPH",
        "middle_name": "AVERY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-27",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301117095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.