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Individual provider Active NPI

Lafayette Nicholas Richmond, MD

  • Diagnostic Radiology Physician
  • Traverse City, MI
National Provider Identifier
1992729115
Registry record updated Apr 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
4301406381 Issued in MI
Practice address
1105 Sixth St
Traverse City, MI 49684-2345
Phone
(231) 935-0497
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X 4301406381 MI
Diagnostic Radiology Physician 2085R0202X 4301406381 MI Primary

Addresses

Primary practice location

1105 Sixth St
Traverse City, MI 49684-2345

Mailing address

PO Box 30516
Dept 9516
Lansing, MI 48909
Phone (231) 935-0497

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100106000792 MI Practitioner - Diagnostic Radiology 7618059510 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Wayne State University School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grand Traverse Radiologists PCGroup PAC ID 6002866407, 32 clinicians

Practice addresses (Care Compare)

1105 6TH St
Traverse City, MI 49684-2345
Phone (231) 935-5000

Hospital & facility affiliations

  • Munson Medical Center Hospital, Traverse City, MI, CCN 230097
  • Munson Healthcare Cadillac Hospital Hospital, Cadillac, MI, CCN 230081
  • Munson Healthcare Otsego Memorial Hospital Hospital, Gaylord, MI, CCN 230133
  • Kalkaska Memorial Health Center Hospital, Kalkaska, MI, CCN 231301
  • Charlevoix Area Hospital Hospital, Charlevoix, MI, CCN 231322

Merit-based Incentive Payment System (MIPS)

Final score
92.64 of 100Reported as group
Quality
91.34
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301406381MIMDNeuroradiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Traverse Radiologists PC Diagnostic Radiology CurrentSince Jan 1, 2003 Accepting new patients
Dr Richard Burke Pain and Neuromodulation PLLC CurrentSince Aug 11, 2023 Accepting new patients
Novello Imaging PLC CurrentSince Jan 1, 2021 Accepting new patients
Catawba Radiological Associates, Inc. Neuroradiology Past Accepting new patients

Locations

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

4290 Copper Ridge Dr
Ste 100
Traverse City, MI 49684
Phone (231) 421-8505

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

3769 Columbus Pike
Ste 220
Delaware, OH 43015

Organizations & group practices 4

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588118400000",
    "number": "1992729115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30516",
            "address_2": "DEPT 9516",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "48909",
            "telephone_number": "231-935-0497",
            "fax_number": "231-935-0498"
        },
        {
            "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": "231-935-0497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHMOND",
        "first_name": "LAFAYETTE",
        "middle_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "MI",
            "license": "4301406381",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301406381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.