Individual provider Active NPI

Marc E Lame, M.D.

  • Surgery Physician
  • Charlevoix, MI
National Provider Identifier
1902833163
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
4301045907 Issued in MI
Practice address
14695 Park Ave
Charlevoix, MI 49720-1929
Phone
(231) 547-2812
Fax
(231) 547-3067
NPI assigned
Jun 26, 2006
Last updated
Apr 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 4301045907 MI Primary

Addresses

Primary practice location

14695 Park Ave
Charlevoix, MI 49720-1929

Mailing address

14695 Park Ave
Charlevoix, MI 49720-1929
Phone (231) 547-2812

Other identifiers 1

IdentifierTypeStateIssuer
1918377MedicaidMI

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
I20100308000025 MI Practitioner - General Surgery 7416841267 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Healthcare Grayling CurrentSince Mar 1, 2024 Accepting new patients
Munson Healthcare Otsego Memorial Hospital Current Accepting new patients
Munson Healthcare Grayling Surgery CurrentSince Mar 1, 2024 Accepting new patients
Munson Healthcare Charlevoix Hospital Surgery CurrentSince Aug 1, 2015 Accepting new patients
Munson Healthcare Grayling Current Accepting new patients
Munson Healthcare Otsego Memorial Hospital CurrentSince Mar 1, 2024 Accepting new patients
Munson Healthcare Otsego Memorial Hospital Surgery CurrentSince Mar 1, 2024 Accepting new patients

Locations

3781 Momentum Pl
Chicago, IL 60689

14651 W Upright St
Charlevoix, MI 49720
Phone (231) 547-4477

14700 Lake Shore Dr
Charlevoix, MI 49720
Phone (231) 547-3840

829 N Center Ave
Gaylord, MI 49735
Phone (989) 731-2100

829 N Center Ave
Ste 120
Gaylord, MI 49735
Phone (989) 731-7987

1010 W North Down River Rd
Grayling, MI 49738
Phone (989) 348-0800

1250 E Michigan Ave
Grayling, MI 49738
Phone (989) 348-0550

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1902833163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14695 PARK AVE",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497201929",
            "telephone_number": "231-547-2812",
            "fax_number": "231-547-3067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14695 PARK AVE",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497201929",
            "telephone_number": "231-547-2812",
            "fax_number": "231-547-3067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAME",
        "first_name": "MARC",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301045907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1918377",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlevoix, MI

Sources for this page

Verify at the official NPI Registry.