NPIMap

Organization Active NPI

Munson Healthcare Cadillac

  • General Acute Care Hospital
  • Cadillac, MI
National Provider Identifier
1841696754
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
MUNSON HEALTHCARE CADILLAC
Practice address
400 Hobart St
Cadillac, MI 49601-2331
Phone
(231) 876-7200
NPI assigned
Nov 5, 2014
Last updated
Aug 19, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
MUNSON HEALTHCAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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

Authorized official

Name
Peter Marinoff
Title
President/Ceo South Reigon
Phone
(231) 876-7321

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X NU Primary

Addresses

Primary practice location

400 Hobart St
Cadillac, MI 49601-2331

Mailing address

1105 Sixth St
Traverse City, MI 49684-2349
Phone (231) 935-5000

Other identifiers 2

IdentifierTypeStateIssuer
00009OtherMIBLUE CROSS
230081MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150211000241 MI Part A Provider - Hospital 6305161514 1 other NPI on this enrollment
Practice locations: Cadillac, MI; Traverse City, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1841696754. Details of each certification follow.

Hospital certification: CCN 230081

Legal name
MUNSON HEALTHCARE CADILLAC
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Jan 7, 1988
Beds
117
Ownership / control type
Church
Most recent change of ownership
Feb 1, 2015 (1 total)
Organization structure
CorporationNon-profit
Incorporated
Jun 17, 2014 in MI
Enrollment address
400 Hobart St
Cadillac, MI 49601-2331
Other Hospital Practice Location
Hospital subgroups
Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Munson Healthcare Cadillac HospitalCCN 230081 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Church
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Munson Infusion Pharmacy8 organizations share this tax ID, including this one
Part of
Munson Manor Hospitality House

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Interoperability endpoints

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

Ownership & related parties

All disclosed owners & managing parties 22

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Andrew Page Individual Corporate OfficerTrustee Jan 1, 2024
Ruth Hoppe Individual Corporate DirectorTrustee Jan 1, 2022
Paul Konopacki Individual Corporate OfficerCfo Jan 1, 2024
W-2 Managing Employee Jan 1, 2024
Operational/Managerial ControlCfo Jan 1, 2024
Vincent Schultz Individual Corporate OfficerTrustee Jan 1, 2024
Thomas Veryser Individual Corporate DirectorTrustee Jan 1, 2022
Kenneth D Bloem Individual Corporate DirectorTrustee Jan 1, 2022
Timothy Nelson Individual Corporate DirectorTreasurer Jan 1, 2022
David Menegebier Individual Corporate OfficerTrustee Jan 1, 2024
Edward Lanphier Individual Corporate DirectorBoard Member Jan 1, 2026
Kathy Dixon Individual Corporate DirectorTrustee Jan 1, 2022
Mary Sanders Individual Corporate DirectorTrustee Jan 1, 2022
Elaine Wood Individual Corporate DirectorTrustee Jan 1, 2022
Munson Healthcare Organization, Traverse City, MI Corporation Operational/Managerial Control Feb 1, 2015 100%
Peter E Marinoff Individual Corporate Director Dec 13, 2023 100%
W-2 Managing Employee Jan 1, 2022
Edwin a Ness Individual Corporate OfficerCeo Jul 1, 2004
Owen Roberts Individual Corporate OfficerVice Chairperson Feb 1, 2015
Corporate DirectorTrustee Jan 1, 2022
Bruce Zenner Individual Corporate DirectorTrustee Jan 1, 2022
Sakura Takano Individual Corporate DirectorTrustee Jan 1, 2022
Kristine Thomas Individual Corporate DirectorTrustee Jan 1, 2022
Brian Postma Individual Corporate DirectorTrustee Jan 1, 2022
Dino Recchia Individual Corporate OfficerTrustee Jan 1, 2024
Jennifer King Individual Corporate OfficerTrustee Jan 1, 2024

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 24

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 24

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 26

Affiliated clinicians 515

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 515

NPI Registry JSON

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

{
    "created_epoch": "1415145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724025600000",
    "number": "1841696754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 SIXTH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842349",
            "telephone_number": "231-935-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HOBART ST",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496012331",
            "telephone_number": "231-876-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUNSON HEALTHCARE CADILLAC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MUNSON HEALTHCARE",
        "enumeration_date": "2014-11-05",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A",
        "authorized_official_last_name": "MARINOFF",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "PRESIDENT/CEO SOUTH REIGON",
        "authorized_official_telephone_number": "231-876-7321"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "00009",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "230081",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cadillac, MI

Sources for this page

Verify at the official NPI Registry.