Individual provider Active NPI

Jamie Pintar, PH.D.

  • Clinical Neuropsychologist
  • Traverse City, MI
National Provider Identifier
1932467248
Registry record updated Aug 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
6301013916 Issued in MI
Practice address
12719 S West Bay Shore Dr
Suite #9
Traverse City, MI 49684-5489
Phone
(231) 714-7054
NPI assigned
Apr 25, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301013916 MI
Clinical Neuropsychologist 103G00000X 6301013916 MI Primary

Addresses

Primary practice location

12719 S West Bay Shore Dr
Suite #9
Traverse City, MI 49684-5489

Mailing address

12719 S West Bay Shore Dr Ste 9
Traverse City, MI 49684-5489
Phone (231) 735-1903

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130117000016 MI Practitioner - Clinical Psychologist 9436302783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12719 S W Bay Shore Dr
Traverse City, MI 49684-5489
Phone (231) 943-1031

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6301013916MIMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pintar Psychological Services, PC Clinical Neuropsychologist CurrentSince Nov 27, 2012 Accepting new patients
Pintar Psychological Services, PC PastSince Nov 27, 2012 Accepting new patients

Locations

12719 S West Bay Shore Dr
Traverse City, MI 49684
Phone (231) 943-1031

12719 S West Bay Shore Dr
Ste 9
Traverse City, MI 49684
Phone (231) 714-7054

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": "1335312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786060800000",
    "number": "1932467248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12719 S WEST BAY SHORE DR STE 9",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496845489",
            "telephone_number": "231-735-1903",
            "fax_number": "231-943-1032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12719 S WEST BAY SHORE DR",
            "address_2": "SUITE #9",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496845489",
            "telephone_number": "231-714-7054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINTAR",
        "first_name": "JAMIE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-25",
        "last_updated": "2026-08-07",
        "certification_date": "2026-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301013916",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MI",
            "license": "6301013916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.