Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

GRAND TRAVERSE PATHOLOGY, PLLC
NPI 1306868427
Pathology - Anatomic Pathology & Clinical Pathology in Traverse City, MI

Active since July 25, 2006
1105 6TH ST, TRAVERSE CITY, MI 49684(231) 935-0499 Get Directions Write a Review

NPPES record last updated: October 17, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 17, 2026, Jun 12, 2020, Mar 16, 2020 and 1 more (4 updates tracked since 2020).

About Grand Traverse Pathology, Pllc NPPES

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

GRAND TRAVERSE PATHOLOGY, PLLC (NPI 1306868427) is a healthcare organization registered as an anatomic pathology & clinical pathology in Traverse City, Michigan and active in the NPI registry since July 2006. The organization maintains a secondary practice location in Cadillac and lists Amy W Ferguson, President, as its authorized official.

NPPES Registry Identity

NPI1306868427
Entity TypeOrganization
Primary Taxonomy207ZP0102X
Legal Business NameGRAND TRAVERSE PATHOLOGY, PLLC
Location Address1105 6TH STTraverse City, MI 49684-2345
Mailing AddressPo Box 9099Longview, TX 75608-9099 · (903) 663-4800 · Fax (419) 223-2726
Organization SubpartNo
Authorized OfficialAmy W FergusonPresident · (231) 935-6108
Enumeration DateJuly 25, 2006
Last NPPES UpdateOctober 17, 20264 updates tracked since enumeration
NPPES CertifiedOctober 17, 2026
✔ NPI 1306868427 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPathology · Anatomic Pathology & Clinical PathologyAllopathic & Osteopathic Physicians
Taxonomy Code207ZP0102X
Definition
A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.
1105 6TH ST, Traverse City, MI 49684

Secondary Practice Location 1

Location 1400 Hobart StCadillac, MI 49601-2331 · Phone (231) 876-7200

Other Identifiers 8

Other53481AMI · Health Alliance Plan
OtherCB1092MI · Railroad Medicare
Other018175MI · Midwest Health Plan
Other820MI · Priority Health
Other0B87602MI · Bcbs
Other36478MI · Community Choice Of Mi
Other510047MI · Preferred Choices
OtherXX01516MI · Healthplus

Accepted 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)

Grand Traverse Pathology, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

13

Medicare enrollment records show 13 clinicians reassign Medicare billing to Grand Traverse Pathology, PLLC, which bills Medicare for the services they deliver. Of these, 12 practice at this address. They are listed nearest first.

Clinicians, nearest first (13)

Pathology
NPI 1417979337
1105 6TH ST
Traverse City, MI 49684
(231) 935-0499
✔ PECOSSame address
Pathology
NPI 1013903848
1105 SIXTH ST
Traverse City, MI 49684
(231) 935-6100
✔ PECOS✔ Accepts MedicareSame address
Pathology
NPI 1891215463
1105 SIXTH ST
Traverse City, MI 49684
(231) 935-6100
✔ PECOS✔ Accepts MedicareSame address
Pathology
NPI 1376567131
1105 6TH ST
Traverse City, MI 49684
(231) 935-0499
✔ PECOS✔ Accepts MedicareSame address
Pathology
NPI 1649380387
1105 6TH ST
Traverse City, MI 49684
(231) 935-0499
✔ PECOS✔ Accepts MedicareSame address
Pathology
NPI 1205850088
1105 6TH ST
Traverse City, MI 49684
(231) 935-0499
✔ PECOSSame address
Pathology
NPI 1871935528
1105 6TH ST
Traverse City, MI 49684
(231) 935-6100
✔ PECOS✔ Accepts MedicareSame address
Pathology
NPI 1780608570
1105 6TH ST
Traverse City, MI 49684
(231) 935-0499
✔ PECOS✔ Accepts MedicareSame address
Pathology
NPI 1184831299
1105 SIXTH ST
Traverse City, MI 49684
(231) 935-6100
✔ PECOS✔ Accepts MedicareSame address
Pathology
NPI 1629422407
1105 SIXTH ST
Traverse City, MI 49684
(231) 935-6100
✔ PECOS✔ Accepts MedicareSame address
Pathology
NPI 1356723415
1105 SIXTH ST
Traverse City, MI 49684
(231) 935-6100
✔ PECOS✔ Accepts MedicareSame address
Pathology
NPI 1720292493
1105 SIXTH ST
Traverse City, MI 49684
(231) 935-6100
✔ PECOS✔ Accepts MedicareSame address
Pathology
NPI 1215003694
1 GENESYS PKWY
Grand Blanc, MI 48439
(810) 606-5560
✔ PECOS✔ Accepts Medicare163 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 Grand Traverse Pathology, PLLC's NPI number?

The NPI number for Grand Traverse Pathology, PLLC is 1306868427. It was assigned to this organization in the NPPES registry on July 25, 2006.

Where is Grand Traverse Pathology, PLLC located?

Grand Traverse Pathology, PLLC is located at 1105 6th St, Traverse City, MI 49684. The listed phone number is (231) 935-0499.

What is Grand Traverse Pathology, PLLC's specialty?

The primary specialty registered for this NPI is Pathology, specializing in Anatomic Pathology & Clinical Pathology, with taxonomy code 207ZP0102X.

Is Grand Traverse Pathology, PLLC enrolled in Medicare?

Yes. Grand Traverse Pathology, PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Grand Traverse Pathology, PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 13 clinicians, all in Pathology, reassign their Medicare billing to Grand Traverse Pathology, PLLC. 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, 12 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Grand Traverse Pathology, PLLC accept?

Health plans from Blue Cross Blue Shield of Michigan Mutual Insurance Company and Priority Health list Grand Traverse Pathology, PLLC 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 Pathology, PLLC was last updated on October 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 days 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.