NPIMap

Organization Active NPI

Schoolcraft Memorial Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Manistique, MI
National Provider Identifier
1700938370
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
SCHOOLCRAFT MEMORIAL HOSPITAL
Practice address
7870W US Highway 2
Manistique, MI 49854-8992
Phone
(906) 341-3200
Fax
(906) 341-1878
NPI assigned
Jan 17, 2007
Last updated
Mar 26, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
SCHOOLCRAFT MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Authorized official

Name
Andy Bertapelle
Title
Chief Executive Officer
Phone
(906) 341-3221

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X Primary

Addresses

Primary practice location

7870W US Highway 2
Manistique, MI 49854-8992

Mailing address

7870W US Highway 2
Manistique, MI 49854-8992
Phone (906) 341-3200

Other identifiers 1

IdentifierTypeStateIssuer
63 5182167MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090728000643 MI Part A Provider - Critical Access Hospital 4082525118 Receives reassigned benefits from 1 practitioner
Practice locations: Manistique, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1700938370. Details of each certification follow.

Hospital certification: CCN 23Z303

Legal name
SCHOOLCRAFT MEMORIAL HOSPITAL
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 1990 in MI
Enrollment address
7870W US Highway 2
Manistique, MI 49854-8992
Other Hospital Practice Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Schoolcraft Memorial Hosp6 organizations share this tax ID, including this one
Part of
Schoolcraft Memorial Hosp

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
James Blanchard Individual Corporate DirectorBoard Member Jan 1, 2019
Kevin Knaffla Individual Corporate DirectorBoard Member Aug 13, 2020
Andrew Joseph Bertapelle Individual Corporate OfficerCeo Aug 31, 2022
W-2 Managing Employee Aug 31, 2022
Operational/Managerial Control Aug 31, 2022
Eric J Price Individual Corporate OfficerCfo Jan 2, 2023
W-2 Managing Employee Jan 2, 2023
Operational/Managerial Control Jan 2, 2023
Cindy Olli Individual Corporate DirectorBoard Member Jun 25, 2020
Lisa Lee Desjarden Individual W-2 Managing EmployeeBusiness Office Supervisor Feb 24, 2014
Howard Parmentier Individual Corporate DirectorBoard Member Jun 24, 2021
Peter J Hood Individual Corporate Director Mar 31, 2018
Ryan Fausett Individual Corporate Director Oct 28, 2021

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711411200000",
    "number": "1700938370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7870W US HIGHWAY 2",
            "city": "MANISTIQUE",
            "state": "MI",
            "postal_code": "498548992",
            "telephone_number": "906-341-3200",
            "fax_number": "906-341-1878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7870W US HIGHWAY 2",
            "city": "MANISTIQUE",
            "state": "MI",
            "postal_code": "498548992",
            "telephone_number": "906-341-3200",
            "fax_number": "906-341-1878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCHOOLCRAFT MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SCHOOLCRAFT MEMORIAL HOSPITAL",
        "enumeration_date": "2007-01-17",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A",
        "authorized_official_last_name": "BERTAPELLE",
        "authorized_official_first_name": "ANDY",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "906-341-3221"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "63 5182167",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manistique, MI

Sources for this page

Verify at the official NPI Registry.