Individual provider Active NPI

Carley Therese Flegler, PA

  • Physician Assistant
  • Traverse City, MI
National Provider Identifier
1861762122
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601006265 Issued in MI
Practice address
1105 Sixth St
Traverse City, MI 49684-2345
Phone
(231) 935-7514
Fax
(231) 392-0039
NPI assigned
Jan 4, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601006265 MI Primary

Addresses

Primary practice location

1105 Sixth St
Traverse City, MI 49684-2345

Mailing address

1105 Sixth St
Traverse City, MI 49684-2345

Other practice location 1

4069 Lake Dr SE
Suite 313
Grand Rapids, MI 49546-8816
Phone (616) 267-7333

Other practice location 2

1221 Sixth St Ste 100
Traverse City, MI 49684-2359
Phone (231) 392-8400

Other practice location 3

3537 W Front St
Traverse City, MI 49684-7941
Phone (231) 935-5880

Other practice location 4

1221 Sixth St Ste 300
Traverse City, MI 49684-2360
Phone (231) 935-0322

Other practice location 5

217 S Madison St
Traverse City, MI 49684-2321
Phone (231) 392-8400

Other practice location 6

1011 Sunnyside Dr
Cadillac, MI 49601-8735
Phone (231) 779-2565

Other names 1

  • Carley Therese Breen Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120503000563 MI Practitioner - Physician Assistant 1850553090 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Munson Medical CenterGroup PAC ID 3072426287, 377 clinicians

Practice addresses (Care Compare)

1105 6TH St
Traverse City, MI 49684-2345
Phone (231) 935-5000

1121 6TH St
Suite 316
Traverse City, MI 49684-2345
Phone (231) 392-8280

1400 Medical Campus Dr
Traverse City, MI 49684-7823
Phone (231) 935-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601006265MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Healthcare Cadillac CurrentSince Sep 1, 2024 Accepting new patients
Munson Healthcare Cadillac CurrentSince Sep 1, 2024 Accepting new patients
Munson Medical Center CurrentSince Apr 1, 2024 Accepting new patients
Munson Medical Center CurrentSince Apr 1, 2024 Accepting new patients
Munson Medical Center Past Accepting new patients

Locations

3782 Momentum Pl
Chicago, IL 60689

2513 Momentum Pl
Chicago, IL 60689
Phone (231) 935-8031

1011 Sunnyside Dr
Cadillac, MI 49601
Phone (231) 779-2565

1221 Sixth St
Ste 300
Traverse City, MI 49684
Phone (231) 392-0640

1221 Sixth St
Ste 100
Traverse City, MI 49684
Phone (231) 392-8400

1110 Sixth St
Traverse City, MI 49684
Phone (231) 392-8400

1400 Medical Campus Dr
Traverse City, MI 49684
Phone (231) 935-8000

1221 Sixth St
Ste 212
Traverse City, MI 49684
Phone (231) 392-0210

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

Organizations & group practices 7

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 1

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": "1325635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1861762122",
    "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": "496842345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 SIXTH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842345",
            "telephone_number": "231-935-7514",
            "fax_number": "231-392-0039"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4069 Lake Dr SE",
            "address_2": "Suite 313",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495468816",
            "country_code": "US",
            "telephone_number": "616-267-7333",
            "fax_number": "616-267-8040",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1221 Sixth St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496842359",
            "country_code": "US",
            "telephone_number": "231-392-8400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3537 W Front St",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496847941",
            "country_code": "US",
            "telephone_number": "231-935-5880",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1221 Sixth St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496842360",
            "country_code": "US",
            "telephone_number": "231-935-0322",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "217 S Madison St",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496842321",
            "country_code": "US",
            "telephone_number": "231-392-8400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1011 Sunnyside Dr",
            "address_purpose": "LOCATION",
            "city": "Cadillac",
            "state": "MI",
            "postal_code": "496018735",
            "country_code": "US",
            "telephone_number": "231-779-2565",
            "fax_number": "231-775-0744",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLEGLER",
        "first_name": "CARLEY",
        "middle_name": "THERESE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-04",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601006265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLEY",
            "last_name": "BREEN",
            "middle_name": "THERESE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.