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GREAT LAKES EAR NOSE & THROAT SPECIALISTS PC
NPI 1184123150
Otolaryngology in Petoskey, MI

Active since February 06, 2018
1114 CHARLEVOIX AVE, PETOSKEY, MI 49770(231) 489-8151(231) 668-7794 Get Directions Write a Review

NPPES record last updated: September 20, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 15, 2022, Mar 10, 2022 (2 updates tracked since 2022).

About Great Lakes Ear Nose & Throat Specialists Pc NPPES

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

GREAT LAKES EAR NOSE & THROAT SPECIALISTS PC (NPI 1184123150) is a healthcare organization registered as an otolaryngology in Petoskey, Michigan and active in the NPI registry since February 2018. The organization maintains 2 additional practice locations and lists Kevin L Gietzen, Doctor, as its authorized official.

NPPES Registry Identity

NPI1184123150
Entity TypeOrganization
Primary Taxonomy207Y00000X
Legal Business NameGREAT LAKES EAR NOSE & THROAT SPECIALISTS PC
Location Address1114 CHARLEVOIX AVEPetoskey, MI 49770-9701
Mailing Address1114 Charlevoix AvePetoskey, MI 49770-9701 · (231) 489-8151 · Fax (231) 668-7794
Phone(231) 489-8151
Fax(231) 668-7794
Organization SubpartNo
Authorized OfficialKevin L GietzenDoctor · (231) 838-1571
Enumeration DateFebruary 6, 2018
Last NPPES UpdateSeptember 20, 20232 updates tracked since enumeration
NPPES CertifiedSeptember 20, 2023
✔ NPI 1184123150 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
License✔ Licensed in MI · 5101013761
Definition
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
1114 CHARLEVOIX AVE, Petoskey, MI 49770
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Secondary Practice Locations 2

Location 1101 Oxbow DrAlpena, MI 49707-1448 · Phone (231) 489-8151 · Fax (231) 668-7794
Location 2829 N Center Ave Ste 160Gaylord, MI 49735-1598 · Phone (231) 489-8151 · Fax (231) 668-7794

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)

Great Lakes Ear Nose & Throat Specialists Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

7

Medicare enrollment records show 7 clinicians reassign Medicare billing to Great Lakes Ear Nose & Throat Specialists PC, which bills Medicare for the services they deliver. Of these, 4 practice at this address and 5 within 10 miles. They are listed nearest first.

Clinicians, nearest first (7)

Kelsi Churchill
Qualified Audiologist
NPI 1609609411
1114 CHARLEVOIX AVE
Petoskey, MI 49770
(231) 489-8151
✔ Accepts MedicareSame address
Spencer Cross, DNP
Nurse Practitioner
NPI 1699268805
1114 CHARLEVOIX AVE
Petoskey, MI 49770
(231) 489-8151
✔ PECOS✔ Accepts MedicareSame address
Kevin Gietzen, D.O.
Otolaryngology
NPI 1538189154
1114 CHARLEVOIX AVE
Petoskey, MI 49770
(231) 489-8151
✔ PECOS✔ Accepts MedicareSame address
Lindsay Reckinger, AU.D.
Qualified Audiologist
NPI 1467867549
1114 CHARLEVOIX AVE
Petoskey, MI 49770
(231) 489-8151
✔ Accepts MedicareSame address
Milissa Pressey, AGPCNP-BC
Nurse Practitioner
NPI 1073002952
1604 ARROWHEAD
Harbor Springs, MI 49740
(231) 622-1389
✔ PECOS6.6 mi
Kristen Kowalski, AU.D., CCC-A
Qualified Audiologist
NPI 1346529229
101 OXBOW DR
Alpena, MI 49707
(231) 489-8151
✔ Accepts Medicare76 mi
Kaley Mason, FNP-C
Nurse Practitioner
NPI 1770971202
101 OXBOW DR
Alpena, MI 49707
(231) 489-8151
✔ PECOS✔ Accepts Medicare76 mi

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

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 Great Lakes Ear Nose & Throat Specialists PC's NPI number?

The NPI number for Great Lakes Ear Nose & Throat Specialists PC is 1184123150. It was assigned to this organization in the NPPES registry on February 6, 2018.

Where is Great Lakes Ear Nose & Throat Specialists PC located?

Great Lakes Ear Nose & Throat Specialists PC is located at 1114 Charlevoix Ave, Petoskey, MI 49770. The listed phone number is (231) 489-8151.

What is Great Lakes Ear Nose & Throat Specialists PC's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Is Great Lakes Ear Nose & Throat Specialists PC enrolled in Medicare?

Yes. Great Lakes Ear Nose & Throat Specialists PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Great Lakes Ear Nose & Throat Specialists PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians in 3 Medicare specialties reassign their Medicare billing to Great Lakes Ear Nose & Throat Specialists PC. 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 Nurse Practitioner (3), Qualified Audiologist (3) and Otolaryngology (1). Of these, 4 practice at this address and 5 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Great Lakes Ear Nose & Throat Specialists PC accept?

Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Great Lakes Ear Nose & Throat Specialists PC 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 Great Lakes Ear Nose & Throat Specialists PC was last updated on September 20, 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.