Individual provider Active NPI

Sarah J Petschar, NP

  • Family Nurse Practitioner
  • Iron Mountain, MI
National Provider Identifier
1700426384
Registry record updated Jan 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704265445 Issued in MI
Practice address
1711 S Stephenson Ave Ste 300
Iron Mountain, MI 49801-3650
Phone
(906) 774-1633
Fax
(906) 774-4451
NPI assigned
Jan 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704265445 MI Primary

Addresses

Primary practice location

1711 S Stephenson Ave Ste 300
Iron Mountain, MI 49801-3650

Mailing address

1711 S Stephenson Ave Ste 300
Iron Mountain, MI 49801-3650
Phone (906) 774-1633

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sarah-petschar@miwidocs.e-mdsdirect.com Direct

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200225001592 MI Practitioner - Nurse Practitioner 7012344435 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michigan-Wisconsin Family Practice Associates, P.C.Group PAC ID 2264404169, 4 clinicians

Practice addresses (Care Compare)

1711 S Stephenson Ave
Iron Mountain, MI 49801-3650
Phone (906) 774-1633

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan-Wisconsin Family Practice Associates, P.C. CurrentSince Mar 2, 2020 Accepting new patients

Locations

1711 S Stephenson Ave
Ste 300
Iron Mountain, MI 49801
Phone (906) 774-1633

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.

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": "1578614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578614400000",
    "number": "1700426384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 S STEPHENSON AVE STE 300",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498013650",
            "telephone_number": "906-774-1633",
            "fax_number": "906-774-4451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 S STEPHENSON AVE STE 300",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498013650",
            "telephone_number": "906-774-1633",
            "fax_number": "906-774-4451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETSCHAR",
        "first_name": "SARAH",
        "middle_name": "J",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-10",
        "last_updated": "2020-01-10",
        "certification_date": "2020-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704265445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sarah-petschar@miwidocs.e-mdsdirect.com",
            "affiliation": "N",
            "endpointDescription": "direct messaging email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1711 S Stephenson Ave Ste 300",
            "city": "Iron Mountain",
            "state": "MI",
            "country_code": "US",
            "postal_code": "498013650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Iron Mountain, MI

Sources for this page

Verify at the official NPI Registry.