Individual provider Active NPI

Rebekah Sue Noss, OD

  • Optometrist
  • Traverse City, MI
National Provider Identifier
1740448752
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901004483 Issued in MI
Practice address
328 Munson Ave
Traverse City, MI 49686-3096
Phone
(231) 946-8460
NPI assigned
May 27, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901004483 MI Primary

Addresses

Primary practice location

328 Munson Ave
Traverse City, MI 49686-3096

Mailing address

328 Munson Ave Ste a
Traverse City, MI 49686-3097
Phone (231) 946-8460

Other identifiers 1

IdentifierTypeStateIssuer
4290OtherMIMEDICARE PTAN

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110407000043 MI Practitioner - Optometry 6608050174 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mark D Noss OD LLC Optometrist CurrentSince Apr 24, 2025 Accepting new patients
Dr. Mark Noss LLC Optometrist PastSince Apr 24, 2025 Accepting new patients

Locations

328 Munson Ave
Traverse City, MI 49686
Phone (231) 946-8460

328 Munson Ave
Ste A
Traverse City, MI 49686
Phone (231) 946-7700

Organizations & group practices 2

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": "1211846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1740448752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "328 MUNSON AVE STE A",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863097",
            "telephone_number": "231-946-8460",
            "fax_number": "231-946-8507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "328 MUNSON AVE",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863096",
            "telephone_number": "231-946-8460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOSS",
        "first_name": "REBEKAH",
        "middle_name": "SUE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-27",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "4290",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.