McLaren Bay Region
Organization Active NPI Psychiatric Hospital Unit · Bay City, MI
NPI 1831163070 · NPPES record last updated Jul 21, 2020
Key facts
- NPI
- 1831163070
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatric Hospital Unit 273R00000X
- Legal business name
- MCLAREN BAY REGION
- Practice address
- 1900 Columbus Ave
Bay City, MI 48708 - Phone
- (989) 894-3000
- Fax
- (989) 891-8172
- NPI assigned
- Feb 15, 2006
- Organization subpart
- No
Authorized official
- Name
- Danielle C Jacks Porter
- Title
- VP/Cfo
- Phone
- (989) 894-3838
Owners & managing parties with NPI records 4
-
Rajesh Dandamudi, M.D.
-
Praveen Kumar Kamaraju, M.D.
-
Lee Christopher Newton, O.D.
Other NPIs with the same Medicare PAC ID 4
Corporate family (same tax ID) 15
Related certifications (CCN) 1
Facilities with the same owner 58
Practitioners 110
-
Michael Abdul-Malek, D.O.
-
Jonathan D Abramson, M. D.
-
Gassan Alaouie, DO
-
Yousef Bader, MD
-
Janice Elaine Baker, NURSE PRACTITIONER
-
Michael Bedell, PA
-
Cristian D. Boboc, M.D.
-
Taylor Ann Brenz, PA-C
-
Jordyn Lindsey Brown, PA-C
-
Joshua Christy, MD
-
Ryan Cox, M.D.
-
Matthew Lawrence D'John, M.D.
-
Bassam J Daghman, M.D.
-
Daryl G Damron, PA-C
-
Rajesh Dandamudi, M.D.
-
Olivia R Drier, PA-C
-
Melissa Duchene, FNP-BC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Hospital certification: CCN 23S041
- Legal name
- MCLAREN BAY REGION
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 1900 Columbus Ave
Bay City, MI 48708-6831 - Hospital subgroups
- Psychiatric unit
All disclosed owners & managing parties 14
| Name | Role | Since | Share |
|---|---|---|---|
| Thomas Keller |
Corporate Director |
Sep 23, 2025 | |
| W-2 Managing Employee |
Sep 23, 2025 | ||
| Operational/Managerial Control |
Sep 23, 2025 | ||
| Matthew Felan |
Corporate Director |
Aug 31, 2022 | |
| Praveen K Kamaraju |
Corporate Officer |
Jun 11, 2025 | |
| Chad Grant |
Corporate Director |
Aug 7, 2021 | |
| Rajesh Dandamudi |
Corporate Director |
Feb 1, 2016 | |
| Terrence J Cherwin |
Corporate Director |
Aug 22, 2002 | |
| McLaren Health Care Corporation |
5% Or Greater Direct Ownership Interest | Dec 12, 2001 | 100% |
| Gary E Bosco |
Corporate Director |
Dec 13, 1994 | |
| Dominic Monastiere |
Corporate Director |
Aug 17, 1999 | |
| Heather Gallegos |
Corporate Director |
Feb 1, 2018 | |
| Lee C Newton |
Corporate Director |
Feb 1, 2018 | |
| Amy L Rodriguez |
Corporate Director |
Jan 15, 2003 | |
| Michael Johnson |
Corporate Director |
Jan 8, 2026 | |
| W-2 Managing Employee |
Jan 8, 2026 | ||
| Operational/Managerial Control |
Jan 8, 2026 | ||
| Mitzi Dimitroff |
Corporate Director |
May 14, 2003 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070217000046 | MI | Part a Provider - Hospital | 5597659011 | Practice locations: Bay City, MI |
National Provider Directory
- Tax ID family
- Bay Medical Center
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Hospital Unit | 273R00000X | Yes |
Addresses
Primary practice location
1900 Columbus Ave
Bay City, MI 48708
Mailing address
1900 Columbus Ave
Bay City, MI 48708-6831
Phone (989) 894-3000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831163070 | Medicaid | MI | |
| 23S041 | Other | MI | MEDICARE PROVIDER NUMBER |
Other providers in Bay City, MI
- McLaren Bay Region
- McLaren Bay Region
- McLaren Bay Region
- McLaren Bay Region
- McLaren Bay Region
- McLaren Bay Region
- McLaren Bay Special Care
- McLaren Health Management Group
- McLaren Medical Group
- McLaren Medical Group
All providers in Bay City, MI · Psychiatric Hospital Unit in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2020. 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.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.