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GRAND TRAVERSE RADIOLOGISTS PC
NPI 1760404891
Radiology - Diagnostic Radiology in Traverse City, MI

Active since July 25, 2006
1105 SIXTH ST, TRAVERSE CITY, MI 49684(231) 935-0497 Get Directions Write a Review

NPPES record last updated: April 29, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 10, 2020, Aug 24, 2017, Aug 17, 2017 (3 updates tracked since 2017).

About Grand Traverse Radiologists Pc NPPES

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

GRAND TRAVERSE RADIOLOGISTS PC (NPI 1760404891) is a healthcare organization registered as a diagnostic radiology in Traverse City, Michigan and active in the NPI registry since July 2006. The organization lists Michelle M Lung, President, as its authorized official.

NPPES Registry Identity

NPI1760404891
Entity TypeOrganization
Primary Taxonomy2085R0202X
Legal Business NameGRAND TRAVERSE RADIOLOGISTS PC
Location Address1105 SIXTH STTraverse City, MI 49684-2345
Mailing AddressPo Box 30516, Dept. 9516Lansing, MI 48909-8016 · (800) 475-6112 · Fax (423) 826-1286
Phone(231) 935-0497
Organization SubpartNo
Authorized OfficialMichelle M LungPresident · (231) 935-0497
Enumeration DateJuly 25, 2006
Last NPPES UpdateApril 29, 20203 updates tracked since enumeration
NPPES CertifiedApril 29, 2020
✔ NPI 1760404891 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
1105 SIXTH ST, Traverse City, MI 49684
Open in Google Maps ↗

Other Identifiers 15

Other280047MI · Federal Black Lung
OtherXX00308MI · Healthplus Of Mi
Other10399MI · M-care
Other4055MI · Priority Health
Other53556AMI · Health Alliance Plan
Other803002MI · Community Care Plan
Other008081MI · Midwest Health Plan
Other0B87605MI · Blue Cross Blue Shield
Medicaid12088500WI
Other134232100MI · Us Dept. Of Labor
OtherN16010MI · Northmed Hmo
OtherCA3471MI · Railroad Medicare
Other104756MI · Care Choices
Other27837MI · Community Choice Mi
Other104756MI · Preferred Choices

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, Priority Health.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)

Grand Traverse Radiologists Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

35

Medicare enrollment records show 35 clinicians reassign Medicare billing to Grand Traverse Radiologists PC, which bills Medicare for the services they deliver. Of these, 17 practice at this address and 19 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 3

Diagnostic Radiology29
Interventional Radiology5
Nurse Practitioner1

Nearest to this location (20)

See all 35
William Allsopp, D.O.
Interventional Radiology
NPI 1598029407
1105 SIXTH ST
Traverse City, MI 49684
(231) 935-0497
✔ PECOS✔ Accepts MedicareSame address
Kayla Berigan, M.D.
Diagnostic Radiology
NPI 1396190641
1105 SIXTH ST
Traverse City, MI 49684
(231) 935-0497
✔ PECOS✔ Accepts MedicareSame address
Daniel Boss, MD
Diagnostic Radiology
NPI 1346460623
1105 SIXTH ST
Traverse City, MI 49684
(231) 935-0497
✔ PECOS✔ Accepts MedicareSame address
Frederick Brodeur, MD
Interventional Radiology
NPI 1710901236
1105 SIXTH ST
Traverse City, MI 49684
(231) 935-0497
✔ PECOS✔ Accepts MedicareSame address
Britton Carter, M.D.
Diagnostic Radiology
NPI 1598085268
1105 SIXTH ST STE 100
Traverse City, MI 49684
(231) 935-5000
✔ PECOS✔ Accepts MedicareSame address
Leah Davis, D.O.
Diagnostic Radiology
NPI 1568787034
1105 SIXTH ST
Traverse City, MI 49684
(231) 935-5000
✔ PECOS✔ Accepts MedicareSame address
Patrick Gartland, M.D.
Diagnostic Radiology
NPI 1649329426
1105 SIXTH ST
Traverse City, MI 49684
(231) 935-0497
✔ PECOS✔ Accepts MedicareSame address
Ryan Hoenicke, MD
Diagnostic Radiology
NPI 1477604874
1105 SIXTH ST
Traverse City, MI 49684
(123) 193-5500
✔ PECOS✔ Accepts MedicareSame address
Ryan Holmes, MD
Diagnostic Radiology
NPI 1124042304
1105 SIXTH ST
Traverse City, MI 49684
(231) 935-0497
✔ PECOS✔ Accepts MedicareSame address
Jesse Johnson, M.D.
Diagnostic Radiology
NPI 1033146212
1105 SIXTH ST
Traverse City, MI 49684
(231) 935-0497
✔ PECOS✔ Accepts MedicareSame address
Anthony Livorine, M.D.
Diagnostic Radiology
NPI 1083849160
1105 SIXTH ST
Traverse City, MI 49684
(231) 935-0497
✔ PECOS✔ Accepts MedicareSame address
Michelle Lung, MD
Interventional Radiology
NPI 1275557456
1105 SIXTH ST
Traverse City, MI 49684
(231) 935-0497
✔ PECOS✔ Accepts MedicareSame address
John Nay
Diagnostic Radiology
NPI 1942520788
1105 SIXTH ST
Traverse City, MI 49684
(231) 935-0497
✔ PECOS✔ Accepts MedicareSame address
Andrew Osetek, M.D.
Diagnostic Radiology
NPI 1073950945
1105 SIXTH ST
Traverse City, MI 49684
(231) 935-5000
✔ PECOS✔ Accepts MedicareSame address
Clark Phelps, MD
Diagnostic Radiology
NPI 1437173630
1105 SIXTH ST
Traverse City, MI 49684
(231) 935-0497
✔ PECOS✔ Accepts MedicareSame address
Lafayette Richmond, MD
Diagnostic Radiology
NPI 1992729115
1105 SIXTH ST
Traverse City, MI 49684
(231) 935-0497
✔ PECOS✔ Accepts MedicareSame address
Edward Walsh, MD
Diagnostic Radiology
NPI 1003070954
1105 SIXTH ST
Traverse City, MI 49684
(231) 935-0497
✔ PECOS✔ Accepts MedicareSame address
Kimberly Johnson, M.D.
Diagnostic Radiology
NPI 1467682971
1105 SIXTH STREET SUITE#100
49684 Traverse City, Mi (grand Traverse), MI 49684
(231) 935-5000
✔ PECOS✔ Accepts Medicare5.0 mi
Tate Kern, D.O.
Diagnostic Radiology
NPI 1912357831
1105 SIXTH ST
Traverse City, MI 49684
(231) 935-0497
✔ PECOS✔ Accepts Medicare5.0 mi
Nazima Kathiria, D.O.
Diagnostic Radiology
NPI 1528130523
3264 N EVERGREEN DR NE
Grand Rapids, MI 49525
(616) 363-7272
✔ PECOS✔ Accepts Medicare120 mi
See all 35 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Grand Traverse Radiologists PC's NPI number?

The NPI number for Grand Traverse Radiologists PC is 1760404891. It was assigned to this organization in the NPPES registry on July 25, 2006.

Where is Grand Traverse Radiologists PC located?

Grand Traverse Radiologists PC is located at 1105 Sixth St, Traverse City, MI 49684. The listed phone number is (231) 935-0497.

What is Grand Traverse Radiologists PC's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Is Grand Traverse Radiologists PC enrolled in Medicare?

Yes. Grand Traverse Radiologists PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Grand Traverse Radiologists PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 35 clinicians in 3 Medicare specialties reassign their Medicare billing to Grand Traverse Radiologists 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 Diagnostic Radiology (29), Interventional Radiology (5) and Nurse Practitioner (1). Of these, 17 practice at this address and 19 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Grand Traverse Radiologists PC accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company and Priority Health list Grand Traverse Radiologists 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 Grand Traverse Radiologists PC was last updated on April 29, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.