Individual provider Active NPI

Michael L Mawby, M.D.

  • Rheumatology Physician
  • Traverse City, MI
National Provider Identifier
1720084114
Registry record updated Mar 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
4301051186 Issued in MI
Practice address
1115 S Union St
Traverse City, MI 49684-3258
Phone
(231) 935-0550
Fax
(231) 935-0551
NPI assigned
Jun 22, 2005
Last updated
Mar 4, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 4301051186 MI Primary

Addresses

Primary practice location

1115 S Union St
Traverse City, MI 49684-3258

Mailing address

PO Box 728
Traverse City, MI 49685-0728
Phone (231) 935-0550

Other identifiers 7

IdentifierTypeStateIssuer
4324974MedicaidMI
1102802841OtherMIBC/BS OF MI
131101OtherMIUNITED HEALTH CARE
660003547OtherMITRICARE/CHAMPUS
F60038OtherMIPRIORITY
1102802841OtherMIBLUE CARE NETWORK
1720084114OtherMIMICHAEL L MAWBY MD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20051123000260 MI Practitioner - Rheumatology 2163442914 Reassigns benefits to 1 organization
I20220815000180 OH Practitioner - Internal Medicine 2163442914 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Wayne State University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Infusion Associates PLLCGroup PAC ID 0840185203, 18 clinicians

Practice addresses (Care Compare)

3230 Eagle Park Dr NE
Suite 101
Grand Rapids, MI 49525-7047
Phone (616) 954-0600

418 Munson Ave
Traverse City, MI 49686-3042
Phone (614) 954-0600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.21 of 100Reported as group
Quality
88.24
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301051186MIMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Id Consultants Inc CurrentSince Aug 1, 2024 Accepting new patients
Infusion Associates of Ohio LLC CurrentSince Jul 19, 2022 Accepting new patients
Infusion Associates PLLC CurrentSince Jan 31, 2020 Accepting new patients
Hospitalists of West Michigan PC Current Accepting new patients
Little People Urgent Care PLC PastSince Mar 1, 2016 Accepting new patients

Locations

250 W Eisenhower Pkwy
Ste 130
Ann Arbor, MI 48103

44720 Hayes Rd
Ste 200
Clinton Township, MI 48038

830 W Lake Lansing Rd
East Lansing, MI 48823
Phone (517) 333-3777

830 W Lake Lansing Rd
Ste 150
East Lansing, MI 48823
Phone (517) 897-9200

1600 S Beacon Blvd
Grand Haven, MI 49417
Phone (614) 954-0600

1600 S Beacon Blvd
Ste 100
Grand Haven, MI 49417
Phone (614) 954-0600

3230 Eagle Park Dr NE
Ste 101
Grand Rapids, MI 49525

3310 Eagle Park Dr NE
Ste 200
Grand Rapids, MI 49525

4343 Chicago Dr SW
Grandville, MI 49418

39475 Lewis Dr
Ste 140
Novi, MI 48377
Phone (248) 489-0766

1399 W Centre Ave
Portage, MI 49024
Phone (269) 615-1657

1115 S Union St
Traverse City, MI 49684
Phone (231) 935-0550

363 W Big Beaver Rd
Ste 125
Troy, MI 48084

363 W Big Beaver Rd
Ste 126
Troy, MI 48084
Phone (248) 220-5230

155 Lincoln Way W
Ste A109
Massillon, OH 44647
Phone (216) 488-1060

50 Normandy Dr
Ste 1
Painesville, OH 44077

2000 Regency Ct
Ste 100A
Toledo, OH 43623
Phone (833) 394-0600

2211 Crocker Rd
Ste 170
Westlake, OH 44145
Phone (216) 360-9480

Interoperability endpoints

  • Direct secure messaging: michael.mawby@direct.aoc.nextgenshare.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393891200000",
    "number": "1720084114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 728",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496850728",
            "telephone_number": "231-935-0550",
            "fax_number": "231-935-0551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 S UNION ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496843258",
            "telephone_number": "231-935-0550",
            "fax_number": "231-935-0551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAWBY",
        "first_name": "MICHAEL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2014-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MI",
            "license": "4301051186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4324974",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF MI",
            "identifier": "1102802841",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "131101",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE/CHAMPUS",
            "identifier": "660003547",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIORITY",
            "identifier": "F60038",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "1102802841",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHAEL L MAWBY MD",
            "identifier": "1720084114",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.