Individual provider Active NPI

Michele Safko Squires, M.D.

  • Anesthesiology Physician
  • South Bend, IN
National Provider Identifier
1831176429
Registry record updated Oct 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
01054643A Issued in IN
Practice address
416 E Monroe St
Suite 200
South Bend, IN 46601-2360
Phone
(574) 232-8119
Fax
(574) 288-0235
NPI assigned
Dec 27, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 01054643A IN Primary

Addresses

Primary practice location

416 E Monroe St
Suite 200
South Bend, IN 46601-2360

Mailing address

416 E Monroe St
Suite 200
South Bend, IN 46601-2360
Phone (574) 232-8119

Other identifiers 1

IdentifierTypeStateIssuer
200422280MedicaidIN

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
I20140129000719 MI Practitioner - Anesthesiology 1355536137 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Indiana University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Munson Medical GroupGroup PAC ID 8820277015, 191 clinicians
Munson Medical CenterGroup PAC ID 3072426287, 377 clinicians

Practice addresses (Care Compare)

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

4100 Park Forest Dr
Traverse City, MI 49684-7331
Phone (231) 392-8900

419 S Coral St
Kalkaska, MI 49646-2503
Phone (231) 258-7500

Hospital & facility affiliations

  • Munson Medical Center Hospital, Traverse City, MI, CCN 230097
  • Kalkaska Memorial Health Center Hospital, Kalkaska, MI, CCN 231301

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Medical Center Anesthesiology CurrentSince Feb 1, 2025 Accepting new patients
Munson Medical Group CurrentSince Sep 16, 2022 Accepting new patients
Munson Medical Center CurrentSince Feb 1, 2025 Accepting new patients
Northern Anesthesia Providers PC Anesthesiology CurrentSince Nov 1, 2013 Accepting new patients
Munson Medical Group Current Accepting new patients
Munson Medical Group Anesthesiology CurrentSince Sep 16, 2022 Accepting new patients

Locations

2891 Momentum Pl
Chicago, IL 60689

602 Jackson St
Petoskey, MI 49770
Phone (231) 348-2795

416 Connable Ave
Petoskey, MI 49770
Phone (231) 487-4000

4100 Park Forest Dr
Traverse City, MI 49684
Phone (231) 392-8900

1105 Sixth St
Ste 103
Traverse City, MI 49684
Phone (231) 935-6455

1200 Sixth St
Ste 200
Traverse City, MI 49684

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 2

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": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223251200000",
    "number": "1831176429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 E MONROE ST",
            "address_2": "SUITE 200",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466012360",
            "telephone_number": "574-232-8119",
            "fax_number": "574-288-0235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 E MONROE ST",
            "address_2": "SUITE 200",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466012360",
            "telephone_number": "574-232-8119",
            "fax_number": "574-288-0235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SQUIRES",
        "first_name": "MICHELE",
        "middle_name": "SAFKO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-27",
        "last_updated": "2008-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01054643A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200422280",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.