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BROOKSIDE FAMILY MEDICINE A CENTER FOR HEALTH AND WELL-BEING PLC
NPI 1699957571
Family Medicine in Traverse City, MI

Active since December 03, 2007CLIA 23D0960257 · Microscopy
647 E EIGHTH ST, TRAVERSE CITY, MI 49686(231) 922-0400(855) 586-8399 Get Directions Write a Review

NPPES record last updated: February 15, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Brookside Family Medicine A Center For Health And Well-being Plc NPPES

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

BROOKSIDE FAMILY MEDICINE A CENTER FOR HEALTH AND WELL-BEING PLC (NPI 1699957571) is a healthcare organization registered as a family medicine in Traverse City, Michigan and active in the NPI registry since December 2007. The organization holds a CLIA Microscopy certificate valid through May 4, 2027 and lists Debra Kay Graetz, Owner/physician, as its authorized official.

NPPES Registry Identity

NPI1699957571
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameBROOKSIDE FAMILY MEDICINE A CENTER FOR HEALTH AND WELL-BEING PLC
Location Address647 E EIGHTH STTraverse City, MI 49686-2630
Mailing Address647 E Eighth StTraverse City, MI 49686-2630 · (231) 922-0400 · Fax (855) 586-8399
Phone(231) 922-0400
Fax(855) 586-8399
Organization SubpartNo
Authorized OfficialDebra Kay GraetzOwner/physician · (231) 922-0400
Enumeration DateDecember 3, 2007
Last NPPES UpdateFebruary 15, 2024
NPPES CertifiedFebruary 15, 2024
✔ NPI 1699957571 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MI · 4301068214
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.
647 E EIGHTH ST, Traverse City, MI 49686
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Other Identifiers 3

Medicaid4102107MI
Other0280363MI · Blue Care Network
Other0B810140MI · Bcbs Of Mi Group

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)

Brookside Family Medicine A Center For Health And Well-being Plc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Brookside Family Medicine A Center For Health And Well-Being Plc, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (4)

Debra Graetz, MD
Family Practice
NPI 1104963115
647 E EIGHTH ST
Traverse City, MI 49686
(231) 922-0400
✔ PECOS✔ Accepts MedicareSame address
Jennifer Lyon, D.O.
Family Practice
NPI 1528283199
647 E EIGHTH ST
Traverse City, MI 49686
(231) 900-0400
✔ PECOS✔ Accepts MedicareSame address
Kathryn Krezoski Evans, D.O.
Family Practice
NPI 1194136721
9975 W OTTAWA AVE
Empire, MI 49630
(231) 835-2088
✔ PECOS✔ Accepts Medicare22 mi
Molly Craven, D.O.
Family Practice
NPI 1528273026
230 TEMPLE ST
Mason, MI 48854
(517) 676-9066
162 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) 23D0960257

Brookside Family Medicine · Traverse City, MI
Active · expires May 4, 2027
CLIA Number23D0960257
Laboratory TypePhysician Office
Certificate Effective DateMay 5, 2025
Certificate Expiration DateMay 4, 2027
Laboratory DirectorDebra K. Graetz
Laboratory Phone(231) 922-0400
Laboratory LocationBrookside Family Medicine647 E 8th St, Traverse City, MI 49686
CLIA data matches this NPI record on: 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 Brookside Family Medicine A Center For Health And Well-Being Plc's NPI number?

The NPI number for Brookside Family Medicine A Center For Health And Well-Being Plc is 1699957571. It was assigned to this organization in the NPPES registry on December 3, 2007.

Where is Brookside Family Medicine A Center For Health And Well-Being Plc located?

Brookside Family Medicine A Center For Health And Well-Being Plc is located at 647 E Eighth St, Traverse City, MI 49686. The listed phone number is (231) 922-0400.

What is Brookside Family Medicine A Center For Health And Well-Being Plc's specialty?

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

Is Brookside Family Medicine A Center For Health And Well-Being Plc enrolled in Medicare?

Yes. Brookside Family Medicine A Center For Health And Well-Being Plc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Brookside Family Medicine A Center For Health And Well-Being Plc?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians, all in Family Practice, reassign their Medicare billing to Brookside Family Medicine A Center For Health And Well-Being Plc. 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 at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Brookside Family Medicine A Center For Health And Well-Being Plc hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 23D0960257) is associated with this NPI, valid through May 4, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Brookside Family Medicine A Center For Health And Well-Being Plc accept?

Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Brookside Family Medicine A Center For Health And Well-Being Plc 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 Brookside Family Medicine A Center For Health And Well-Being Plc was last updated on February 15, 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.