NPIMap

Organization Active NPI

Grayling Anesthesia Associates PC

  • Anesthesiology Physician
  • Grayling, MI
National Provider Identifier
1710313648
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
GRAYLING ANESTHESIA ASSOCIATES PC
Practice address
1100 E Michigan Ave
Grayling, MI 49738-1312
Phone
(877) 580-9349
NPI assigned
Sep 24, 2013
Last updated
Jun 18, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Authorized official

Name
Dr. Marc E Koch, MDNPI 1629069497
Title
President
Phone
(877) 476-6642

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NU
Anesthesiology Physician 207L00000X NU Primary

Addresses

Primary practice location

1100 E Michigan Ave
Grayling, MI 49738-1312

Mailing address

450 Mamaroneck Ave Ste 201
Harrison, NY 10528-2436
Phone (914) 637-3510

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140411000827 MI Part B Supplier - Clinic/Group Practice 1052543758 Receives reassigned benefits from 40 practitioners
Practice locations: Grayling, MI

National Provider Directory

National Provider Directory

Locations

450 Mamaroneck Ave
Ste 201
Harrison, NY 10528
Phone (877) 476-6642

Practitioners & affiliated clinicians

Practitioners 41

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.

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1379980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750204800000",
    "number": "1710313648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 MAMARONECK AVE STE 201",
            "city": "HARRISON",
            "state": "NY",
            "postal_code": "105282436",
            "telephone_number": "914-637-3510",
            "fax_number": "914-365-6307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E MICHIGAN AVE",
            "city": "GRAYLING",
            "state": "MI",
            "postal_code": "497381312",
            "telephone_number": "877-580-9349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAYLING ANESTHESIA ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-24",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A",
        "authorized_official_last_name": "KOCH",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "877-476-6642",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grayling, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2025; 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.