BIRCH SHORE PRIMARY CARE PLLC
NPI 1396609467
Internal Medicine in Manistee, MI
About Birch Shore Primary Care Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BIRCH SHORE PRIMARY CARE PLLC (NPI 1396609467) is a healthcare organization registered as an internal medicine in Manistee, Michigan and active in the NPI registry since December 2025. The organization holds a CLIA Waiver certificate valid through August 24, 2028 and lists Charles Jay Vandenberg, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
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)
Birch Shore Primary Care Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Birch Shore Primary Care PLLC, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (2)
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 Waiver 23D2349571
Birch Shore Primary Care · Manistee, MIFrequently 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 Birch Shore Primary Care PLLC's NPI number?
The NPI number for Birch Shore Primary Care PLLC is 1396609467. It was assigned to this organization in the NPPES registry on December 12, 2025.
Where is Birch Shore Primary Care PLLC located?
Birch Shore Primary Care PLLC is located at 3021 Schoedel Rd, Manistee, MI 49660. The listed phone number is (231) 397-9229.
What is Birch Shore Primary Care PLLC's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Birch Shore Primary Care PLLC enrolled in Medicare?
Yes. Birch Shore Primary Care PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Birch Shore Primary Care PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Birch Shore Primary Care PLLC, in Family Practice and Internal Medicine. 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, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Birch Shore Primary Care PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 23D2349571) is associated with this NPI, valid through August 24, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Birch Shore Primary Care PLLC accept?
Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Birch Shore Primary Care 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 Birch Shore Primary Care PLLC was last updated on May 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Birch Shore Primary Care Pllc · NPI 1396609467
Internal Medicine organization in Manistee, Michigan. Organization record, active in the CMS NPPES registry since December 12, 2025.
## Identity
- **NPI:** 1396609467 (Entity type: Organization)
- **Enumerated:** December 12, 2025
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **Organization subpart:** Yes (part of Northwoods Health Collective)
- **Authorized official:** Charles Vandenberg, PRESIDENT
## Practice location
- **Address:** 3021 SCHOEDEL RD, Manistee, MI 49660-9753
- **Phone:** (231) 397-9229
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (1), Internal Medicine (1); 2 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 27, 2026
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1396609467) · Data from the CMS NPPES public registry.