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MARY NUSSBAUM
NPI 1396479440
Physician Assistant in Traverse City, MI

Active since July 14, 2022PECOS Enrolled
550 MUNSON AVE STE 200, TRAVERSE CITY, MI 49686(231) 935-8717(231) 935-9230 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, Jul 14, 2022 (2 updates tracked since 2022).

About Mary Nussbaum NPPES

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

MARY NUSSBAUM (NPI 1396479440) is an individual physician assistant in Traverse City, Michigan and active in the NPI registry since July 2022. She is enrolled in Medicare PECOS, is affiliated with Munson Medical Center, and maintains a secondary practice location in Omaha.

NPPES Registry Identity

NPI1396479440
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMARY NUSSBAUM
Location Address550 MUNSON AVE STE 200Traverse City, MI 49686-3580
Mailing Address550 Munson Ave Ste 200Traverse City, MI 49686-3580 · (319) 358-7172 · Fax (231) 935-9230
Phone(231) 935-8717
Fax(231) 935-9230
Sole ProprietorYes
Medical School CMSNebraska College Of MedicineGraduated 2023
Enumeration DateJuly 14, 2022
Last NPPES UpdateApril 3, 20242 updates tracked since enumeration
NPPES CertifiedApril 3, 2024
✔ NPI 1396479440 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
550 MUNSON AVE STE 200, Traverse City, MI 49686
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Secondary Practice Location 1

Location 12326 S 118th CtOmaha, NE 68144-2928 · Phone (402) 612-9566

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, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mary Nussbaum is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID244671691
PECOS Enrollment IDI20240516000112
Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 7

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Destruction of precancer skin growth, 2-14 growths 17003
This procedure involves removing 2-14 precancerous skin growths. The growths are treated to prevent them from potentially developing into skin cancer. The process is safe, with minimal discomfort, and promotes healthier skin.
288 services73 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
138 services123 patients
Destruction of precancer skin growth, 1 growth 17000
"Destruction of precancer skin growth" is a procedure that eliminates a single precancerous skin growth. This is done to prevent it from developing into skin cancer. The growth may be removed using various methods such as cryotherapy (freezing), laser therapy, or topical medications.
117 services105 patients
Destruction of skin growth, 1-14 growths 17110
"Destruction of skin growth" refers to a procedure where 1-14 abnormal skin growths are removed. This is done using methods such as freezing, burning, or laser therapy. It helps prevent the growth from causing discomfort or turning into a more serious condition.
68 services60 patients
Biopsy of related skin growth, first growth 11102
A biopsy of a skin growth involves taking a small sample of the growth to examine it under a microscope. This helps determine if the growth is harmful. The procedure is typically quick, with minimal discomfort. It's a crucial step in ensuring your skin's health.
40 services40 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
39 services37 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Munson Medical Center

Acute Care Hospitals · Traverse City, MI
5/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number230097
Location1105 Sixth StreetTraverse City, MI 49684 · Grand Traverse County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49686 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.74 typical visit price
range $54.34 – $166.68
Typical copayment $21.18 (range $13.58 – $41.67)
Most-billed visit code 99203
Established Patient
$68.07 typical visit price
range $17.09 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

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

MS. BRITTANY CHANNING-NOBLE LISTER M.D.
Dermatology
550 MUNSON AVE STE 200
TRAVERSE CITY, MI 49686
Grand Traverse County (231) 935-8717

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 Mary Nussbaum's NPI number?

The NPI number for Mary Nussbaum is 1396479440. It was assigned to this individual provider in the NPPES registry on July 14, 2022.

Where is Mary Nussbaum located?

Mary Nussbaum practices at 550 Munson Ave Ste 200, Traverse City, MI 49686. The listed phone number is (231) 935-8717.

What is Mary Nussbaum's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Mary Nussbaum enrolled in Medicare?

Yes. Mary Nussbaum is registered in the Medicare PECOS enrollment system.

What insurance does Mary Nussbaum accept?

Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Mary Nussbaum 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.

Is Mary Nussbaum affiliated with any hospitals?

According to CMS data, Mary Nussbaum is affiliated with Munson Medical Center.

When was this NPI record last updated?

The NPPES record for Mary Nussbaum 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.