Andrea L Stoecker, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101025622 Issued in MI

Practice address

818 Red Dr Ste 100
Traverse City, MI 49684-4729

Phone

(231) 333-1331

Fax

(231) 259-1001

NPI assigned

Feb 16, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 1, 2020 through Jul 1, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• This Osteopathic Life, PLC

  • Clinic/Center
  • Traverse City, MI
  • NPI 1851856272
  NPD (past)

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

{
    "created_epoch": "1487203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1972042562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 RED DR STE 100",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496844729",
            "telephone_number": "231-333-1331",
            "fax_number": "231-259-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 RED DR STE 100",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496844729",
            "telephone_number": "231-333-1331",
            "fax_number": "231-259-1001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 W Greenlawn Ave",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "489102819",
            "country_code": "US",
            "telephone_number": "517-975-7888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STOECKER",
        "first_name": "ANDREA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-16",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101025622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Mary Stocking, PHARM.D.
• Alyssa Mae Stockwell
• Jessie Stockwell, PTA
• Catherine B Stoddard, MD
• Jenna Rose Stoddard, FNP
• Kathryn Sarah Stogner
• Shea Stokes
• Samantha Stolar, MOT, OTR/L
• Anna T Stone, MD
• Rachel Stone, RN BSN

• Family Medicine Physician in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.