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BAYSIDE FAMILY & SPORTS MEDICINE PC
NPI 1629251129
Family Medicine in Petoskey, MI

Active since December 07, 2007CLIA 23D0955653 · Microscopy
2325 SUMMIT PARK DR, SUITE 3, PETOSKEY, MI 49770(231) 439-5100(231) 439-9292 Get Directions Write a Review

NPPES record last updated: April 10, 2012. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Bayside Family & Sports Medicine Pc NPPES

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

BAYSIDE FAMILY & SPORTS MEDICINE PC (NPI 1629251129) is a healthcare organization registered as a family medicine in Petoskey, Michigan and active in the NPI registry since December 2007. The organization holds a CLIA Microscopy certificate valid through January 5, 2027 and lists Todd Edward Decker, Owner/president, as its authorized official.

NPPES Registry Identity

NPI1629251129
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameBAYSIDE FAMILY & SPORTS MEDICINE PC
Location Address2325 SUMMIT PARK DR, SUITE 3Petoskey, MI 49770-8774
Mailing Address2325 Summit Park Dr, Suite 3Petoskey, MI 49770-8774 · (231) 439-5100 · Fax (231) 439-9292
Phone(231) 439-5100
Fax(231) 439-9292
Organization SubpartNo
Authorized OfficialTodd Edward DeckerOwner/president · (231) 439-5100
Enumeration DateDecember 7, 2007
Last NPPES UpdateApril 10, 2012
✔ NPI 1629251129 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
2325 SUMMIT PARK DR, Petoskey, MI 49770
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Other Names 1

Other NameBayside Family & Sports Medicine Pc

Other Identifiers 1

Medicare PINP27540001MI

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, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Bayside Family & Sports Medicine Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by November 30, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateMichiganEnrollment IDO20060209000544Non-DME Part B · Clinic/Group PracticeDue dateNovember 30, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Bayside Family & Sports Medicine PC, which bills Medicare for the services they deliver. Of these, 4 practice at this address and 5 within 10 miles. They are listed nearest first.

Clinicians, nearest first (5)

Todd Decker, MD
Family Practice
NPI 1871600676
2325 SUMMIT PARK DR SUITE 3
Petoskey, MI 49770
(231) 439-5100
✔ PECOS✔ Accepts MedicareSame address
Lisa Hoffman, FNP-C
Nurse Practitioner
NPI 1164449765
2325 SUMMIT PARK DR SUITE 3
Petoskey, MI 49770
(231) 439-5100
✔ PECOS✔ Accepts MedicareSame address
Margaret Bovee, FNP-C
Nurse Practitioner
NPI 1649815366
2325 SUMMIT PARK DR STE 3
Petoskey, MI 49770
(231) 439-5100
✔ PECOS✔ Accepts MedicareSame address
Todd Sheperd, MD
Family Practice
NPI 1679597785
2325 SUMMIT PARK DR SUITE 3
Petoskey, MI 49770
(231) 439-5100
✔ PECOS✔ Accepts MedicareSame address
Michelle Beigle
Nurse Practitioner
NPI 1346625738
1619 ANDERSON RD
Petoskey, MI 49770
(231) 417-6010
✔ PECOS✔ Accepts Medicare2.8 mi

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 for Provider-Performed Microscopy Procedures (PPMP) 23D0955653

Bayside Family & Sports Medicine · Petoskey, MI
Active · expires Jan 5, 2027
CLIA Number23D0955653
Laboratory TypePhysician Office
Certificate Effective DateJanuary 6, 2025
Certificate Expiration DateJanuary 5, 2027
Laboratory DirectorTodd E. Decker
Laboratory Phone(231) 439-5100
Laboratory LocationBayside Family & Sports Medicine2325 Summit Park Drive Suite 3, Petoskey, MI 49770
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

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 Bayside Family & Sports Medicine PC's NPI number?

The NPI number for Bayside Family & Sports Medicine PC is 1629251129. It was assigned to this organization in the NPPES registry on December 7, 2007.

Where is Bayside Family & Sports Medicine PC located?

Bayside Family & Sports Medicine PC is located at 2325 Summit Park Dr Suite 3, Petoskey, MI 49770. The listed phone number is (231) 439-5100.

What is Bayside Family & Sports Medicine PC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Bayside Family & Sports Medicine PC enrolled in Medicare?

Yes. Bayside Family & Sports Medicine PC is registered in the Medicare PECOS enrollment system.

When is Bayside Family & Sports Medicine PC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Michigan, Clinic/Group Practice) is due for revalidation by November 30, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Bayside Family & Sports Medicine PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 2 Medicare specialties reassign their Medicare billing to Bayside Family & Sports Medicine PC. 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. The largest specialties are Nurse Practitioner (3) and Family Practice (2). Of these, 4 practice at this address and 5 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Bayside Family & Sports Medicine PC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 23D0955653) is associated with this NPI, valid through January 5, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Bayside Family & Sports Medicine PC accept?

Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Bayside Family & Sports Medicine 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 Bayside Family & Sports Medicine PC was last updated on April 10, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.