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GRAND TRAVERSE OPHTHALMOLOGY CLINIC PC
NPI 1265426514
Ophthalmology in Traverse City, MI

Active since September 01, 2005CLIA 23D2078847 · Waiver
929 BUSINESS PARK DR, TRAVERSE CITY, MI 49686(231) 947-6246(231) 947-8864 Get Directions Write a Review

NPPES record last updated: April 3, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 3, 2024, May 20, 2020, Jun 13, 2016 (3 updates tracked since 2016).

About Grand Traverse Ophthalmology Clinic Pc NPPES

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

GRAND TRAVERSE OPHTHALMOLOGY CLINIC PC (NPI 1265426514) is a healthcare organization registered as an ophthalmology in Traverse City, Michigan and active in the NPI registry since September 2005. The organization holds a CLIA Waiver certificate valid through June 4, 2028 and lists Deanne L Musser, Billing Manager, as its authorized official.

NPPES Registry Identity

NPI1265426514
Entity TypeOrganization
Primary Taxonomy207W00000X
Legal Business NameGRAND TRAVERSE OPHTHALMOLOGY CLINIC PC
Location Address929 BUSINESS PARK DRTraverse City, MI 49686-8683
Mailing Address929 Business Park DrTraverse City, MI 49686-8683 · (231) 947-6246 · Fax (231) 947-8864
Phone(231) 947-6246
Fax(231) 947-8864
Organization SubpartNo
Authorized OfficialDeanne L MusserBilling Manager · (231) 932-4336
Enumeration DateSeptember 1, 2005
Last NPPES UpdateApril 3, 20243 updates tracked since enumeration
NPPES CertifiedApril 3, 2024
✔ NPI 1265426514 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
Also ListedOptometristTaxonomy 152W00000X
929 BUSINESS PARK DR, Traverse City, MI 49686
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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, BlueCross BlueShield of Tennessee.Insurance ›

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 23D2078847

Grand Traverse Ophthalmology Clinic P C · Traverse City, MI
Active · expires Jun 4, 2028
CLIA Number23D2078847
Laboratory TypePhysician Office
Certificate Effective DateJune 5, 2026
Certificate Expiration DateJune 4, 2028
Laboratory DirectorPetra C. Von Kulajta
Laboratory Phone(231) 932-4336
Laboratory LocationGrand Traverse Ophthalmology Clinic P C929 Business Park Drive, Traverse City, MI 49686
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JENNIFER ANN LINTZ OD
Optometrist
929 BUSINESS PARK DR
TRAVERSE CITY, MI 49686
Grand Traverse County (231) 947-6246
DR. MATTHEW P MADION M.D.
Ophthalmology
929 BUSINESS PARK DR
TRAVERSE CITY, MI 49686
Grand Traverse County (231) 947-6246
DR. ROSEANNA MARIE DAVID O.D.
Optometrist
929 BUSINESS PARK DR
TRAVERSE CITY, MI 49686
Grand Traverse County (231) 947-6246
MARY LEANN BOOMER SCOTT O.D.
Optometrist
929 BUSINESS PARK DR
TRAVERSE CITY, MI 49686
Grand Traverse County (231) 947-6246
DR. RICHARD J ABBOTT O.D.
Optometrist
929 BUSINESS PARK DR
TRAVERSE CITY, MI 49686
Grand Traverse County (231) 947-6246
JOHN R. MCMANUS M.D.
Ophthalmology
929 BUSINESS PARK DR
TRAVERSE CITY, MI 49686
Grand Traverse County (231) 947-6246
DR. JEFFREY N WENTZLOFF M.D.
Ophthalmology
929 BUSINESS PARK DR
TRAVERSE CITY, MI 49686
Grand Traverse County (231) 947-6246
DR. KENNETH H MUSSON M.D.
Ophthalmology
929 BUSINESS PARK DR
TRAVERSE CITY, MI 49686
Grand Traverse County (231) 947-6246

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 Grand Traverse Ophthalmology Clinic PC's NPI number?

The NPI number for Grand Traverse Ophthalmology Clinic PC is 1265426514. It was assigned to this organization in the NPPES registry on September 1, 2005.

Where is Grand Traverse Ophthalmology Clinic PC located?

Grand Traverse Ophthalmology Clinic PC is located at 929 Business Park Dr, Traverse City, MI 49686. The listed phone number is (231) 947-6246.

What is Grand Traverse Ophthalmology Clinic PC's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Does Grand Traverse Ophthalmology Clinic PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D2078847) is associated with this NPI, valid through June 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Grand Traverse Ophthalmology Clinic PC accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company and BlueCross BlueShield of Tennessee list Grand Traverse Ophthalmology Clinic 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 Grand Traverse Ophthalmology Clinic PC was last updated on April 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.