Individual provider Active NPI

Joshua R Meyerson, M.D.

  • Pediatrics Physician
  • Charlevoix, MI
National Provider Identifier
1851383533
Registry record updated Aug 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
JM 066688 Issued in MI
Practice address
220 W Garfield Ave
Charlevoix, MI 49720-1631
Phone
(231) 547-6523
Fax
(231) 547-6238
NPI assigned
Aug 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X JM 066688 MI Primary

Addresses

Primary practice location

220 W Garfield Ave
Charlevoix, MI 49720-1631

Mailing address

220 W Garfield Ave
Charlevoix, MI 49720-1631
Phone (231) 547-6523

Other identifiers 1

IdentifierTypeStateIssuer
104577979MedicaidMI

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
I20150610002116 MI Practitioner - Pediatric Medicine 8820319296 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Tulane University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

100 Woods Cir
Suite 200
Alpena, MI 49707-1443
Phone (989) 356-4507

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
JM 066688MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
District Health Department No. 4 CurrentSince May 1, 2015 Accepting new patients
Northwest Michigan Community Health Agency PastSince Aug 23, 2020 Accepting new patients

Locations

100 Woods Cir
Ste 200
Alpena, MI 49707
Phone (989) 356-4507

825 S Huron St
Ste 1
Cheboygan, MI 49721
Phone (231) 627-8850

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376524800000",
    "number": "1851383533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 W GARFIELD AVE",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497201631",
            "telephone_number": "231-547-6523",
            "fax_number": "231-547-6238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 W GARFIELD AVE",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497201631",
            "telephone_number": "231-547-6523",
            "fax_number": "231-547-6238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYERSON",
        "first_name": "JOSHUA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2013-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "JM 066688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104577979",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlevoix, MI

Sources for this page

Verify at the official NPI Registry.