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UP MEDICAL GROUP - PORTAGE EXPRESS CARE
NPI 1164106910
Clinic/Center - Rural Health in Calumet, MI

Active since June 12, 2023CLIA 23D2077796 · Waiver
56720 CALUMET AVE STE B, CALUMET, MI 49913(906) 481-8952(906) 337-4049 Get Directions Write a Review

NPPES record last updated: October 12, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 12, 2023, Jun 21, 2023, Jun 12, 2023 (3 updates tracked since 2023).

About Up Medical Group - Portage Express Care NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

UP MEDICAL GROUP - PORTAGE EXPRESS CARE (NPI 1164106910) is a healthcare organization registered as a rural health in Calumet, Michigan and active in the NPI registry since June 2023. The organization holds a CLIA Waiver certificate valid through May 14, 2028 and lists Monica Bowman, President, as its authorized official.

NPPES Registry Identity

NPI1164106910
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NamePORTAGE PHYSICIAN PRACTICES INC
Location Address56720 CALUMET AVE STE BCalumet, MI 49913-1967
Mailing Address330 Seven Springs WayBrentwood, TN 37027-5098 · (615) 920-7000
Phone(906) 481-8952
Fax(906) 337-4049
Organization SubpartNo
Authorized OfficialMonica BowmanPresident · (615) 920-7000
Enumeration DateJune 12, 2023
Last NPPES UpdateOctober 12, 20233 updates tracked since enumeration
NPPES CertifiedOctober 12, 2023
✔ NPI 1164106910 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
56720 CALUMET AVE STE B, Calumet, MI 49913
Open in Google Maps ↗

Other Names 1

Doing Business AsUp Medical Group - Portage Express Care

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Up Medical Group - Portage Express Care is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

129

Medicare enrollment records show 129 clinicians reassign Medicare billing to Up Medical Group - Portage Express Care, which bills Medicare for the services they deliver. Of these, 30 practice within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 23

Emergency Medicine33
Orthopedic Surgery22
Nurse Practitioner19
Internal Medicine10
Family Practice7
Diagnostic Radiology5
Anesthesiology4
General Surgery4
15 other specialties25

Nearest to this location (20)

See all 129
Jenny Bausano, FNP
Nurse Practitioner
NPI 1003475344
945 9TH ST
Lake Linden, MI 49945
(906) 483-1030
✔ PECOS✔ Accepts Medicare3.8 mi
Michael Salmi, CRNA
Certified Registered Nurse Anesthetist (CRNA)
NPI 1043360431
500 CAMPUS DR
Hancock, MI 49930
(906) 483-1000
✔ Accepts Medicare9.2 mi
Zachary French, MD
Orthopedic Surgery
NPI 1952930968
500 CAMPUS DR
Hancock, MI 49930
(906) 483-1000
✔ PECOS9.3 mi
Terry Kinzel, MD
Internal Medicine
NPI 1023048477
500 CAMPUS DRIVE
Hancock, MI 49930
(906) 483-1300
✔ PECOS✔ Accepts Medicare9.3 mi
Bruce Anderson
Nurse Practitioner
NPI 1386049211
500 CAMPUS DR
Hancock, MI 49930
(906) 483-1000
✔ PECOS✔ Accepts Medicare9.3 mi
Andrea Bouman, MD
Emergency Medicine
NPI 1447612577
500 CAMPUS DR
Hancock, MI 49930
(906) 483-1000
✔ PECOS✔ Accepts Medicare9.3 mi
Jonathan Brueggeman, DPM
Podiatry
NPI 1790836401
500 CAMPUS DRIVE SUITE 2
Hancock, MI 49930
(906) 483-1060
✔ PECOS✔ Accepts Medicare9.3 mi
Jessica Caulkins, FNP-C
Nurse Practitioner
NPI 1316768427
500 CAMPUS DR STE 4
Hancock, MI 49930
(906) 483-1730
✔ PECOS✔ Accepts Medicare9.3 mi
Brooke Esteves, D.O.
Hematology/Oncology
NPI 1265726970
500 CAMPUS DR
Hancock, MI 49930
(906) 483-1000
✔ PECOS✔ Accepts Medicare9.3 mi
Emily Johnson, MD
Emergency Medicine
NPI 1205256286
500 CAMPUS DR
Hancock, MI 49930
(906) 483-1000
✔ PECOS✔ Accepts Medicare9.3 mi
Kirk Klemme, MD
Anesthesiology
NPI 1609836139
500 CAMPUS DR
Hancock, MI 49930
(906) 483-1000
✔ PECOS✔ Accepts Medicare9.3 mi
William Liston, DO
General Surgery
NPI 1265481204
500 CAMPUS DR
Hancock, MI 49930
(906) 483-1040
✔ PECOS✔ Accepts Medicare9.3 mi
Paul Lyle, M.D.
Diagnostic Radiology
NPI 1427131093
500 CAMPUS DR
Hancock, MI 49930
(906) 360-3014
✔ PECOS✔ Accepts Medicare9.3 mi
Julie Meyer, DO
Obstetrics/Gynecology
NPI 1265476360
500 CAMPUS DR
Hancock, MI 49930
(906) 483-1050
✔ PECOS✔ Accepts Medicare9.3 mi
Sarah Pettibone, MD
Family Practice
NPI 1497105431
500 CAMPUS DR
Hancock, MI 49930
(906) 483-1060
✔ PECOS✔ Accepts Medicare9.3 mi
Ronald Ronquist, M.D.
Orthopedic Surgery
NPI 1255340063
500 CAMPUS DR SUITE 1
Hancock, MI 49930
(906) 483-1040
✔ PECOS✔ Accepts Medicare9.3 mi
Timothy Sears, MD
General Surgery
NPI 1063450526
500 CAMPUS DR
Hancock, MI 49930
(906) 483-1040
✔ PECOS✔ Accepts Medicare9.3 mi
Lori Vaughan, MD
Internal Medicine
NPI 1164546289
500 CAMPUS DR
Hancock, MI 49930
(906) 483-1000
✔ PECOS✔ Accepts Medicare9.3 mi
Ronald Voice, MD
Cardiovascular Disease (Cardiology)
NPI 1174521975
500 CAMPUS DR
Hancock, MI 49930
(906) 483-1000
✔ PECOS✔ Accepts Medicare9.3 mi
Keith Wright, DO
Family Practice
NPI 1508836719
500 CAMPUS DR
Hancock, MI 49930
(906) 483-1730
✔ PECOS✔ Accepts Medicare9.3 mi
See all 129 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D2077796

Portage Physician Practices, Inc Dba Up Medical Group- Portage Express Care · Calumet, MI
Active · expires May 14, 2028
CLIA Number23D2077796
Laboratory TypePhysician Office
Certificate Effective DateMay 15, 2026
Certificate Expiration DateMay 14, 2028
Laboratory DirectorPetio V. Kotov
Laboratory Phone(906) 483-1435
Laboratory LocationPortage Physician Practices, Inc Dba Up Medical Group- Portage Express Care56720 Calumet Avenue Suite B, Calumet, MI 49913
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Portage Physician Practices Inc's NPI number?

The NPI number for Portage Physician Practices Inc is 1164106910. It was assigned to this organization in the NPPES registry on June 12, 2023. The provider is doing business as Up Medical Group - Portage Express Care.

Where is Portage Physician Practices Inc located?

Portage Physician Practices Inc is located at 56720 Calumet Ave Ste B, Calumet, MI 49913. The listed phone number is (906) 481-8952.

What is Portage Physician Practices Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Is Portage Physician Practices Inc enrolled in Medicare?

Yes. Portage Physician Practices Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Portage Physician Practices Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 129 clinicians in 23 Medicare specialties reassign their Medicare billing to Portage Physician Practices Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Emergency Medicine (33), Orthopedic Surgery (22) and Nurse Practitioner (19). Of these, 30 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Portage Physician Practices Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D2077796) is associated with this NPI, valid through May 14, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Portage Physician Practices Inc was last updated on October 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.