Joan M Griner Licht, MD

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

License

JG058054 Issued in MI

Practice address

3643 W Front St Ste a
Traverse City, MI 49684-7760

Phone

(231) 935-0620

Fax

(231) 935-0626

NPI assigned

Jul 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Joan M Griner Professional name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Wayne State University School of Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Associates in Dermatology of Traverse City PCGroup PAC ID 4981607298, 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

77.46 of 100Reported as individual

Quality

59.02

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://traversedermatology.mmi.prod.fhir.ema-api.com/fhir/r4/

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.

• Associates in Dermatology of Traverse City PC

  dba Associates in Dermatology of Traverse City

  • Dermatopathology Physician
  • Traverse City, MI
  • NPI 1861430779
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413849600000",
    "number": "1710902945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3643 W FRONT ST",
            "address_2": "SUITE A",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847759",
            "telephone_number": "231-935-0620",
            "fax_number": "231-935-0626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3643 W FRONT ST STE A",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847760",
            "telephone_number": "231-935-0620",
            "fax_number": "231-935-0626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRINER LICHT",
        "first_name": "JOAN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2014-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "MI",
            "license": "JG058054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOAN",
            "last_name": "GRINER",
            "middle_name": "M",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Abigail Griffin, OTD, OTR/L
• Emily Ruth Griffith
• Joel Griffith
• Brooke Grime, PT
• Anna Dianne Grimm, MA
• Camille Griswold, MSN NP
• Nathan Griswold
• Margaret M Grivas, LMSW-CLINICAL
• Michele G Gronberg
• Bailey S Groseclose II, M.D.

• Procedural Dermatology Physician in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Procedural Dermatology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.