ALPINE FAMILY MEDICINE PLC
NPI 1174577720
Family Medicine in Gaylord, MI

Q: What is Alpine Family Medicine Plc's NPI number?

The NPI number for Alpine Family Medicine Plc is 1174577720. It was assigned to this organization in the NPPES registry on May 19, 2006.

Q: What is Alpine Family Medicine Plc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since May 19, 2006CLIA 23D0381657 · Microscopy

652 N OTSEGO AVE, GAYLORD, MI 49735(989) 732-3529(989) 732-7865 Get Directions Write a Review

NPPES record last updated: January 6, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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About Alpine Family Medicine Plc NPPES

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

ALPINE FAMILY MEDICINE PLC (NPI 1174577720) is a healthcare organization registered as a family medicine in Gaylord, Michigan and active in the NPI registry since May 2006. The organization holds a CLIA Microscopy certificate valid through August 31, 2028 and lists Derek David Olson, Md/owner, as its authorized official.

NPPES Registry Identity

NPI1174577720

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameALPINE FAMILY MEDICINE PLC

Location Address652 N OTSEGO AVEGaylord, MI 49735-2502

Mailing Address652 N Otsego AveGaylord, MI 49735-2502 · (989) 732-3529 · Fax (989) 732-7865

Phone(989) 732-3529

Fax(989) 732-7865

Organization SubpartNo

Authorized OfficialDerek David OlsonMd/owner · (989) 732-3529

Enumeration DateMay 19, 2006

Last NPPES UpdateJanuary 6, 2021

NPPES CertifiedJanuary 6, 2021

✔ NPI 1174577720 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in MI · KK030249

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

652 N OTSEGO AVE, Gaylord, MI 49735

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Alpine Family Medicine Plc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 2 clinicians reassign Medicare billing to Alpine Family Medicine Plc, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Derek Olson, M.D.

Family Practice

NPI 1497796007

652 N OTSEGO AVE
Gaylord, MI 49735

(989) 732-3529

✔ PECOS✔ Accepts MedicareSame address

Ashley Groters, NP

Nurse Practitioner

NPI 1225660285

652 N OTSEGO AVE
Gaylord, MI 49735

(989) 732-3529

✔ PECOS✔ Accepts MedicareSame address

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 for Provider-Performed Microscopy Procedures (PPMP) 23D0381657

Alpine Family Medicine · Gaylord, MI

Active · expires Aug 31, 2028

CLIA Number23D0381657

Laboratory TypePhysician Office

Certificate Effective DateSeptember 1, 2026

Certificate Expiration DateAugust 31, 2028

Laboratory DirectorDerek D. Olson

Laboratory Phone(989) 732-3529

Laboratory LocationAlpine Family Medicine652 North Otsego, Gaylord, MI 49735

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform 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 Alpine Family Medicine Plc's NPI number?

The NPI number for Alpine Family Medicine Plc is 1174577720. It was assigned to this organization in the NPPES registry on May 19, 2006.

Where is Alpine Family Medicine Plc located?

Alpine Family Medicine Plc is located at 652 N Otsego Ave, Gaylord, MI 49735. The listed phone number is (989) 732-3529.

What is Alpine Family Medicine Plc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Alpine Family Medicine Plc enrolled in Medicare?

Yes. Alpine Family Medicine Plc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Alpine Family Medicine Plc?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Alpine Family Medicine Plc, in Family Practice and Nurse Practitioner. 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. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Alpine Family Medicine Plc hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 23D0381657) is associated with this NPI, valid through August 31, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Alpine Family Medicine Plc accept?

Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Alpine Family Medicine Plc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Alpine Family Medicine Plc was last updated on January 6, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.