TRU NORTH DERMATOLOGY
NPI 1366906364
Dermatology - MOHS-Micrographic Surgery in Manistee, MI

Q: What is Tru North Dermatology's NPI number?

The NPI number for Tru North Dermatology is 1366906364. It was assigned to this organization in the NPPES registry on January 24, 2019.

Q: What is Tru North Dermatology's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

Active since January 24, 2019CLIA 23D2119620 · Certificate of Compliance

315 OAKGROVE ST, MANISTEE, MI 49660(231) 299-8900 Get Directions Write a Review

NPPES record last updated: November 19, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Nov 19, 2025, Jan 24, 2019 (2 updates tracked since 2019).

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About Tru North Dermatology NPPES

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

TRU NORTH DERMATOLOGY (NPI 1366906364) is a healthcare organization registered as a mohs-micrographic surgery in Manistee, Michigan and active in the NPI registry since January 2019. The organization holds a CLIA Certificate of Compliance certificate valid through March 13, 2027 and lists Jaime Glauch, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1366906364

Entity TypeOrganization

Primary Taxonomy207ND0101X

Legal Business NameTRU NORTH DERMATOLOGY

Location Address315 OAKGROVE STManistee, MI 49660-1176

Mailing Address315 Oak Grove StManistee, MI 49660-1121 · (231) 299-8900

Phone(231) 299-8900

Organization SubpartNo

Authorized OfficialJaime GlauchOffice Manager · (231) 299-8900

Enumeration DateJanuary 24, 2019

Last NPPES UpdateNovember 19, 20252 updates tracked since enumeration

NPPES CertifiedNovember 19, 2025

✔ NPI 1366906364 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatology · MOHS-Micrographic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207ND0101X

Definition

The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.

315 OAKGROVE ST, Manistee, MI 49660

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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)

Tru North Dermatology is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Tru North Dermatology, which bills Medicare for the services this clinician delivers.

Clinician (1)

Douglas Richley, D.O.

Dermatology

NPI 1780025619

315 OAKGROVE ST
Manistee, MI 49660

(231) 299-8900

✔ 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 of Compliance 23D2119620

Tru North Dermatology · Manistee, MI

Active · expires Mar 13, 2027

CLIA Number23D2119620

Laboratory TypePhysician Office

Certificate Effective DateMarch 14, 2025

Certificate Expiration DateMarch 13, 2027

Laboratory DirectorDouglas M. Richley

Laboratory Phone(231) 299-8900

Laboratory LocationTru North Dermatology315 Oak Grove St, Manistee, MI 49660

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

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 Tru North Dermatology's NPI number?

The NPI number for Tru North Dermatology is 1366906364. It was assigned to this organization in the NPPES registry on January 24, 2019.

Where is Tru North Dermatology located?

Tru North Dermatology is located at 315 Oakgrove St, Manistee, MI 49660. The listed phone number is (231) 299-8900.

What is Tru North Dermatology's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

Is Tru North Dermatology enrolled in Medicare?

Yes. Tru North Dermatology is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Tru North Dermatology?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Tru North Dermatology. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Tru North Dermatology hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 23D2119620) is associated with this NPI, valid through March 13, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Tru North Dermatology accept?

Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Tru North Dermatology 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 Tru North Dermatology was last updated on November 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.