Individual provider Active NPI

Kristen N. Maurice, DO

  • Advanced Heart Failure and Transplant Cardiology Physician
  • Traverse City, MI
National Provider Identifier
1730343583
Registry record updated Dec 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Heart Failure and Transplant Cardiology PhysicianTaxonomy code 207RA0001X
License
5101017875 Issued in MI
Practice address
1200 Sixth St Ste 200
Traverse City, MI 49684-2369
Phone
(231) 935-5800
Fax
(231) 935-5799
NPI assigned
Jul 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Heart Failure and Transplant Cardiology Physician 207RA0001X 02004656A IN
Cardiovascular Disease Physician 207RC0000X 02004656A IN
Advanced Heart Failure and Transplant Cardiology Physician 207RA0001X 5101017875 MI Primary

Addresses

Primary practice location

1200 Sixth St Ste 200
Traverse City, MI 49684-2369

Mailing address

1200 Sixth St Ste 200
Traverse City, MI 49684-2369
Phone (231) 935-5800

Other identifiers 1

IdentifierTypeStateIssuer
201307880MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address KMAURICE@direct.mhc.net

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
I20120828000051 MI Practitioner - Advanced Heart Failure and Transplant CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 7911154943 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Advanced Heart Failure and Transplant CardiologyAlso: Cardiovascular Disease (Cardiology), Internal Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Munson Medical CenterGroup PAC ID 3072426287, 377 clinicians
Munson Medical GroupGroup PAC ID 8820277015, 191 clinicians

Practice addresses (Care Compare)

1105 6TH St
Traverse City, MI 49684-2345
Phone (231) 922-9000

1200 6TH St
Suite 200
Traverse City, MI 49684-2369
Phone (231) 935-5800

Hospital & facility affiliations

  • Munson Medical Center Hospital, Traverse City, MI, CCN 230097
  • Munson Healthcare Cadillac Hospital Hospital, Cadillac, MI, CCN 230081
  • Munson Healthcare Otsego Memorial Hospital Hospital, Gaylord, MI, CCN 230133
  • Kalkaska Memorial Health Center Hospital, Kalkaska, MI, CCN 231301
  • Munson Healthcare Manistee Hospital Hospital, Manistee, MI, CCN 230303

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Medical Group Cardiovascular Disease CurrentSince Apr 29, 2019 Accepting new patients
Munson Medical Group CurrentSince Apr 29, 2019 Accepting new patients
Munson Medical Center Current Accepting new patients
Munson Medical Center CurrentSince Apr 29, 2019 Accepting new patients
Munson Medical Center Cardiovascular Disease CurrentSince Apr 29, 2019 Accepting new patients
Munson Medical Center Past Accepting new patients

Locations

2513 Momentum Pl
Chicago, IL 60689
Phone (231) 935-8031

2891 Momentum Pl
Chicago, IL 60689

400 Hobart St
Cadillac, MI 49601
Phone (231) 876-7200

1110 Sixth St
Traverse City, MI 49684
Phone (231) 392-8400

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

1200 Sixth St
Ste 200
Traverse City, MI 49684

Interoperability endpoints

  • Direct secure messaging: kmaurice@direct.mhc.net

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608681600000",
    "number": "1730343583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 SIXTH ST STE 200",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842369",
            "telephone_number": "231-935-5800",
            "fax_number": "231-935-5799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 SIXTH ST STE 200",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842369",
            "telephone_number": "231-935-5800",
            "fax_number": "231-935-5799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAURICE",
        "first_name": "KRISTEN",
        "middle_name": "N.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-10",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Advanced Heart Failure and Transplant Cardiology",
            "state": "IN",
            "license": "02004656A",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IN",
            "license": "02004656A",
            "primary": false
        },
        {
            "code": "207RA0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Advanced Heart Failure and Transplant Cardiology",
            "state": "MI",
            "license": "5101017875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201307880",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "KMAURICE@direct.mhc.net",
            "affiliation": "N",
            "address_1": "1200 Sixth St Ste 200",
            "city": "Traverse City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "496842369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.