Kyrstin Rachael Sedlacek

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

4704318300 Issued in MI

Practice address

4020 Copper VW Ste 104
Traverse City, MI 49684-7041

Phone

(231) 421-6921

NPI assigned

Sep 17, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kyrstin Adams Former name

Electronic endpoints 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Munson Medical GroupGroup PAC ID 8820277015, 191 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Munson Medical Center Hospital, Traverse City, MI, CCN 230097

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

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

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.

• Munson Medical Group

  • Cardiovascular Disease Physician
  • Traverse City, MI
  • NPI 1821398322
  Medicare reassignment Care Compare group NPD
• Chronic Care Management LLC

  • Family Medicine Physician
  • Traverse City, MI
  • NPI 1730506726

  Nurse Practitioner

  Medicare reassignment NPD
• Munson Medical Group

  • Geriatric Medicine (Internal Medicine) Physician
  • Traverse City, MI
  • NPI 1326801440
  NPD
• Munson Medical Center

  • Family Medicine Physician
  • Traverse City, MI
  • NPI 1881623031
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Munson Medical Center

  • General Acute Care Hospital
  • Traverse City, MI
  • NPI 1952307852
  Care Compare affiliation

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

{
    "created_epoch": "1600300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1821604604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9041 KINGSFIELD DR",
            "city": "KINGSLEY",
            "state": "MI",
            "postal_code": "496498709",
            "telephone_number": "231-668-2792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4020 COPPER VW STE 104",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847041",
            "telephone_number": "231-421-6921"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1105 Sixth St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496842345",
            "country_code": "US",
            "telephone_number": "231-935-5800",
            "fax_number": "231-935-5799",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEDLACEK",
        "first_name": "KYRSTIN",
        "middle_name": "RACHAEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-17",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704318300",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4704318300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Ccm@chronic-care.net",
            "affiliation": "N",
            "endpointDescription": "Chronic care email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "4020 Copper Vw Ste 104",
            "city": "Traverse City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "496847041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KYRSTIN",
            "last_name": "ADAMS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sarah Marie Searles, LAC
• Seasons of Life Counseling, PLC
• Sarah Renea Seaver, D.O.
• Dylan Sebagh, DO
• Ashley Robin Sebert
• Tracey Lee Sedlacek, CMP-T, MMT
• Janelle See
• Colin Seguin, D.O.
• Kathleen Wong Seitz, PHD
• Chad Selby

• Cardiovascular Disease Physician in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Cardiovascular Disease Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.