NPIMap

Organization Active NPI

Munson Medical Center

  • Infectious Disease Physician
  • Traverse City, MI
National Provider Identifier
1700960622
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
Legal business name
MUNSON MEDICAL CENTER
Practice address
1221 6TH St
Suite 206
Traverse City, MI 49684-2359
Phone
(231) 935-5090
Fax
(231) 935-5093
NPI assigned
Oct 25, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Bonnie Kruszka
Title
Coo Munson Physician Network
Phone
(231) 935-4995

Other NPIs on the same Medicare enrollment 29

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 29

Corporate family (same tax ID) 27

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

View all 27

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20040108000904 MI Part B Supplier - Clinic/Group Practice 3072426287 Receives reassigned benefits from 568 practitioners
29 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Manistee, MI; Traverse City, MI; Cadillac, MI; Charlevoix, MI; Cheboygan, MI; Elk Rapids, MI; Frankfort, MI; Gaylord, MI…

National Provider Directory

National Provider Directory
Tax ID family
Leroy Futterer MD (28 organizations share this tax ID)

Interoperability endpoints

  • Direct secure messaging: cledtke@direct.mhc.net
  • Direct secure messaging: cgriswold@direct.mhc.net
  • Direct secure messaging: jbott1@direct.mhc.net
  • Direct secure messaging: dsula2@direct.mhc.net

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RI0200X Primary

Addresses

NPPES NPI Registry

Primary practice location

1221 6TH St
Suite 206
Traverse City, MI 49684-2359

Mailing address

1221 6TH St
Suite 206
Traverse City, MI 49684-2359
Phone (231) 935-5090

Other identifiers 3

NPPES NPI Registry
IdentifierTypeStateIssuer
440B812420OtherMIBCBS GROUP NUMBER
CB9942OtherMIRAILROAD GROUP
700B860160OtherMIBCBS GROUP PIN

Other names 1

NPPES NPI Registry
  • Infectious Disease Consultants Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 4, 2024.

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728000000000",
    "number": "1700960622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 6TH ST",
            "address_2": "SUITE 206",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842359",
            "telephone_number": "231-935-5090",
            "fax_number": "231-935-5093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 6TH ST",
            "address_2": "SUITE 206",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842359",
            "telephone_number": "231-935-5090",
            "fax_number": "231-935-5093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUNSON MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A",
        "authorized_official_last_name": "KRUSZKA",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_title_or_position": "COO MUNSON PHYSICIAN NETWORK",
        "authorized_official_telephone_number": "231-935-4995"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "440B812420",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD GROUP",
            "identifier": "CB9942",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP PIN",
            "identifier": "700B860160",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Infectious Disease Consultants",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.