NPIMap

Organization Active NPI

Munson Medical Center

  • Orthopaedic Trauma Physician
  • Traverse City, MI
National Provider Identifier
1992307052
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Trauma PhysicianTaxonomy code 207XX0801X
Legal business name
MUNSON MEDICAL CENTER
Practice address
1105 Sixth St
Traverse City, MI 49684-2345
Phone
(231) 935-5000
NPI assigned
Nov 13, 2020
Last updated
Oct 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2024

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

Authorized official

Name
Bonnie Kruszka
Title
Coo Munson Physician Network
Phone
(231) 935-4995

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Trauma PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207XX0801X Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040108000904 MI Part B Supplier - Clinic/Group Practice 3072426287 Receives reassigned benefits from 568 practitioners
29 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Manistee, MI; Traverse City, MI; Cadillac, MI; Charlevoix, MI; Cheboygan, MI; Elk Rapids, MI; Frankfort, MI; Gaylord, MI…

Other NPIs on the same Medicare enrollment 29

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 29

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1605225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728000000000",
    "number": "1992307052",
    "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",
            "telephone_number": "231-935-5000"
        },
        {
            "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": "231-935-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUNSON MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-13",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A",
        "authorized_official_last_name": "KRUSZKA",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_title_or_position": "COO MUNSON PHYSICIAN NETWORK",
        "authorized_official_telephone_number": "231-935-4995"
    },
    "taxonomies": [
        {
            "code": "207XX0801X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.