Frank Animikwam, MD
Individual provider Active NPI Family Medicine Physician · Petoskey, MI
NPI 1750875712 · NPPES record last updated Dec 11, 2023
Key facts
- NPI
- 1750875712
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 4301114806 (MI)
- Practice address
- 1260 Ajijaak Ave
Petoskey, MI 49770-8330 - Phone
- (231) 242-1700
- Fax
- (231) 242-1717
- NPI assigned
- Jun 21, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Michigan State University College of Human Medicine, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Little Traverse Bay Bands of Odawa Indians
Practice addresses (Care Compare)
1260 Ajijaak Ave
Petoskey, MI 49770-8330
Phone (231) 242-1700
1260 Ajijaak Ave
Petoskey, MI 49770-9252
Hospital & facility affiliations
- McLaren Home Health
- McLaren Northern Michigan
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211109002057 | MI | Practitioner - Family Practice | 0345639530 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301114806 | MI | MD | Family Medicine Physician |
| 5315091721 | MI | MD | Family Medicine Physician |
Interoperability endpoints
- danimikwam810382@direct.ochin.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 5315091721 | MI | |
| Family Medicine Physician | 207Q00000X | 4301114806 | MI | Yes |
Addresses
Primary practice location
1260 Ajijaak Ave
Petoskey, MI 49770-8330
Mailing address
1260 Ajijaak Ave
Petoskey, MI 49770-8330
Phone (231) 242-1700
Other practice location 1
1200 E Michigan Ave Ste 245
Lansing, MI 48912
Phone (517) 364-5710
Other practice location 2
800 E Columbia St
Mason, MI 48854-1381
Phone (517) 244-8940
Other providers in Petoskey, MI
- Kurt B Anderson
- Roy Lee Angel Jr.
- Deanna Angers
- Joseph Angileri
- Michael A Angileri
- Anthony Alessi DPM PC
- Arec Obs LLC
- Peter Scott Armstrong
- Art of Medicine Personalized PLLC
- Associated Retinal Consultants, PC
All providers in Petoskey, MI · Family Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 11, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.