Munson Medical Group
Organization Active NPI Anesthesiology Physician · Traverse City, MI
NPI 1972225571 · NPPES record last updated Nov 5, 2024
Key facts
- NPI
- 1972225571
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Anesthesiology Physician 207L00000X
- Legal business name
- MUNSON MEDICAL GROUP
- Practice address
- 1105 Sixth St
Traverse City, MI 49684-2345 - Phone
- (231) 935-5000
- NPI assigned
- Sep 12, 2022
- Organization subpart
- No
Authorized official
- Name
- Bonnie Kruszka
- Title
- Coo Munson Physican Network
- Phone
- (231) 935-4995
Other NPIs on the same Medicare enrollment 9
Corporate family (same tax ID) 4
Practitioners 57
-
Mark R. Aulicino, M.D.
-
Christy Lynn Baginski, CRNA
-
Bobbi Blakeslee, RN
-
Andrea M Brown, CRNA
-
Kyle Marie Cameron, CRNA, MS
-
John D Cirocco, CRNA
-
Tyler Clack, CRNA
-
Sarah J Eberhard, CRNA
-
Derek Gelven, SRNA
-
David Anthony Hales, M.D
-
Chelsea Halsted, DO
-
Michelle Hodges, CRNA
-
Chelsea Holzworth, CRNA
-
Jessica Lee Hoort, CRNA
-
Taylor Horning, CRNA
-
Olivia Juntila, MD
-
Debora Ann Kaczynski, M.D.
-
Jaclyn N Keiper, CRNA
-
Austin Kerndt, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110120000061 | MI | Part B Supplier - Clinic/Group Practice | 8820277015 |
Receives reassigned benefits from 197 practitioners 9 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Manistee, MI; Petoskey, MI; Prudenville, MI; Sault Saint Marie, MI; Traverse City, MI; Kalkaska, MI; Cadillac, MI; Charlevoix, MI… |
National Provider Directory
- Tax ID family
- Munson Medical Group
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician |
207L00000X | Yes | ||
| Certified Registered Nurse Anesthetist |
367500000X | |||
| Anesthesiologist Assistant |
367H00000X |
Addresses
Primary practice location
1105 Sixth St
Traverse City, MI 49684-2345
Mailing address
1105 Sixth St
Traverse City, MI 49684-2345
Phone (231) 935-5000
Other providers in Traverse City, MI
- Munson Medical Group
- Munson Medical Group
- Munson Medical Group
- Munson Medical Group
- Munson Medical Group
- Munson Services, Inc.
- Elizabeth Ann Muoio
- Murphy Chiropractic, PLC.
- Kimberlee Joy Murphy Clark
- Dustine Kim Murphy
All providers in Traverse City, MI · Anesthesiology Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 5, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.