Individual provider Active NPI

Michael P Bartlett, MD

  • Neuroradiology Physician
  • Midland, MI
National Provider Identifier
1730109752
Registry record updated Apr 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuroradiology PhysicianTaxonomy code 2085N0700X
License
MB054334 Issued in MI
Practice address
4000 Wellness Dr
Midland, MI 48670-0001
Phone
(989) 839-3408
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X MB054334 MI Primary
Diagnostic Radiology Physician 2085R0202X MB054334 MI

Addresses

Primary practice location

4000 Wellness Dr
Midland, MI 48670-0001

Mailing address

4000 Wellness Dr
Midland, MI 48670-0001
Phone (989) 839-3408

Other identifiers 2

IdentifierTypeStateIssuer
1730109752MedicaidMI
300E676040OtherMIBLUE CROSS

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040308000175 MI Practitioner - Diagnostic Radiology 2769370246 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MB054334MIMDNeuroradiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Midland Radiology Associates PC Diagnostic Radiology CurrentSince Jul 1, 1976 Accepting new patients
Mymichigan Medical Center Gladwin Past Accepting new patients
Midland Radiology Associates PC Diagnostic Radiology Past Accepting new patients
Mymichigan Medical Center Midland Past Accepting new patients

Locations

515 Quarter St
Gladwin, MI 48624
Phone (989) 246-6201

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

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333670400000",
    "number": "1730109752",
    "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": "486700001",
            "telephone_number": "989-839-3408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 WELLNESS DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486700001",
            "telephone_number": "989-839-3408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTLETT",
        "first_name": "MICHAEL",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2012-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "MI",
            "license": "MB054334",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "MB054334",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730109752",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "300E676040",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

Verify at the official NPI Registry.