NPIMap

Organization Active NPI

Mymichigan Medical Center Standish

Doing business as Ascension Standish Hospital Standish Family Medicine

  • Rural Health Clinic/Center
  • Standish, MI
National Provider Identifier
1720166010
Registry record updated Jan 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MYMICHIGAN MEDICAL CENTER STANDISH
Doing business as
Ascension Standish Hospital Standish Family Medicine
Mymichigan Family Medicine
Practice address
805 W Cedar St
Standish, MI 48658-9526
Phone
(989) 846-4521
Fax
(989) 846-3541
NPI assigned
Nov 2, 2006
Last updated
Jan 13, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2026

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

Authorized official

Name
Sarah James
Title
Manager Patient Accounting
Phone
(989) 701-4734

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

805 W Cedar St
Standish, MI 48658-9526

Mailing address

4000 Wellness Dr
Midland, MI 48670-2000
Phone (844) 832-1956

Other names 2

  • Ascension Standish Hospital Standish Family Medicine Doing business as
  • MYMICHIGAN FAMILY MEDICINE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080703000459 MI Part A Provider - Rural Health Clinic 0840362224 Practice locations: Standish, MI
O20120114000064 MI Part B Supplier - Clinic/Group Practice 0840362224 Receives reassigned benefits from 16 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Standish, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1720166010. Details of each certification follow.

Rural health clinic certification: CCN 233998

Legal name
MYMICHIGAN MEDICAL CENTER STANDISH
Doing business as
MYMICHIGAN FAMILY MEDICINE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 26, 1995
Last certification
Oct 22, 2024
Ownership / control type
2B
Organization structure
CorporationNon-profit
Enrollment address
805 W Cedar St
Standish, MI 48658-9526
Related CCNs
231305

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

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 3

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D0987747Mymichigan Family Medicine Clinic - Standish805 W Cedar Street, Standish, MI 48658Certificate of waiverApr 20, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Mymichigan Medical Center Standish Organization, Midland, MI Corporation Operational/Managerial Control Aug 1, 2024 100%
Marcia Mastracci Ditmyer Individual Corporate Officer Aug 1, 2024
Bapineedu Maganti Individual Corporate Officer Aug 1, 2024
Mary Catherine Hannah Individual Corporate Director Aug 1, 2024
Steve Meyer Individual Corporate Director Aug 1, 2024
Laurilee McCord Individual W-2 Managing EmployeeCredentialing Coordinator Jul 1, 2018 5%
OtherCredentialing Coordinator Jul 1, 2018
Samantha Hunter Individual W-2 Managing Employee Aug 1, 2024
Heather Bauman Individual Corporate Officer Aug 1, 2024
Mymichigan Health Organization, Midland, MI Chain home office 5% Or Greater Direct Ownership Interest Aug 1, 2024 100%
Michael Erickson Individual Corporate Officer Aug 1, 2024
Mark Flegenheimer Individual Corporate Officer Aug 1, 2024
Andrew Bethune Individual Corporate Officer Aug 1, 2024
Jo S May Individual Corporate OfficerTrustee Jul 1, 2017
Jimmy Greene Individual Corporate Officer Aug 1, 2024

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mymichigan Skilled Nursing FacilityStandish, MI, CCN 235192 Skilled nursing facility 5% Or Greater Indirect Ownership Interest (100%) Aug 1, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 30

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 30

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768262400000",
    "number": "1720166010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 WELLNESS DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486702000",
            "telephone_number": "844-832-1956",
            "fax_number": "989-633-5241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 W CEDAR ST",
            "city": "STANDISH",
            "state": "MI",
            "postal_code": "486589526",
            "telephone_number": "989-846-4521",
            "fax_number": "989-846-3541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYMICHIGAN MEDICAL CENTER STANDISH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2026-01-13",
        "certification_date": "2026-01-13",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "MANAGER PATIENT ACCOUNTING",
        "authorized_official_telephone_number": "989-701-4734"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ascension Standish Hospital Standish Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MYMICHIGAN FAMILY MEDICINE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Standish, MI

Sources for this page

Verify at the official NPI Registry.