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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: August 02, 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 ›

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.

Other Providers at the Same Location NPPES 9

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

TIMOTHY S. JARVI MD PC
Durable Medical Equipment & Medical Supplies
2325 SUMMIT PARK DR, SUITE A
PETOSKEY, MI 49770
Emmet County (231) 348-3636
DR. KATHLEEN MARIE KELLY AU.D.
Audiologist
2325 SUMMIT PARK DR, SUITE B
PETOSKEY, MI 49770
Emmet County (231) 347-1800
MS. LISA M HOFFMAN FNP-C
Nurse Practitioner (Family)
2325 SUMMIT PARK DR, SUITE 3
PETOSKEY, MI 49770
Emmet County (231) 439-5100
AMY CULLEN M.S. CCCA
Audiologist
2325 SUMMIT PARK DR, SUITE B
PETOSKEY, MI 49770
Emmet County (231) 347-1800
DR. ROBERT SCOTT SHEPERD DDS
Dentist (Oral and Maxillofacial Surgery)
2325 SUMMIT PARK DR, SUITE D
PETOSKEY, MI 49770
Emmet County (231) 487-1020
DR. TODD M SHEPERD MD
Family Medicine
2325 SUMMIT PARK DR, SUITE 3
PETOSKEY, MI 49770
Emmet County (231) 439-5100
DR. TIMOTHY SCOTT JARVI MD
Ophthalmology
2325 SUMMIT PARK DR
PETOSKEY, MI 49770
Emmet County (231) 348-3600
TIMOTHY S JARVI MD PC
Ophthalmology
2325 SUMMIT PARK DR
PETOSKEY, MI 49770
Emmet County (231) 348-3600

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.

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.