NORTHWESTERN MICHIGAN DERMATOLOGY PC
NPI 1952410094
Dermatology in Traverse City, MI
About Northwestern Michigan Dermatology Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NORTHWESTERN MICHIGAN DERMATOLOGY PC (NPI 1952410094) is a healthcare organization registered as a dermatology in Traverse City, Michigan and active in the NPI registry since August 2006. The organization lists Maria C Carroll, Secretary, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted 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)
Northwestern Michigan Dermatology Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by March 31, 2027
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.
Clinicians Billing Medicare Through This Organization
3Medicare enrollment records show 3 clinicians reassign Medicare billing to Northwestern Michigan Dermatology PC, which bills Medicare for the services they deliver. Of these, 3 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (3)
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 Northwestern Michigan Dermatology PC's NPI number?
The NPI number for Northwestern Michigan Dermatology PC is 1952410094. It was assigned to this organization in the NPPES registry on August 30, 2006.
Where is Northwestern Michigan Dermatology PC located?
Northwestern Michigan Dermatology PC is located at 550 Munson Ave Suite 200, Traverse City, MI 49686. The listed phone number is (231) 935-8717.
What is Northwestern Michigan Dermatology PC's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is Northwestern Michigan Dermatology PC enrolled in Medicare?
Yes. Northwestern Michigan Dermatology PC is registered in the Medicare PECOS enrollment system.
When is Northwestern Michigan Dermatology 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 March 31, 2027. 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 Northwestern Michigan Dermatology PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Dermatology, reassign their Medicare billing to Northwestern Michigan Dermatology 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. Of these, 3 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Northwestern Michigan Dermatology PC accept?
Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Northwestern Michigan Dermatology 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 Northwestern Michigan Dermatology PC was last updated on September 28, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.
# Northwestern Michigan Dermatology Pc · NPI 1952410094
Dermatology organization in Traverse City, Michigan. Organization record, active in the CMS NPPES registry since August 30, 2006.
## Identity
- **NPI:** 1952410094 (Entity type: Organization)
- **Enumerated:** August 30, 2006
- **Primary specialty:** Dermatology · taxonomy 207N00000X
- **Organization subpart:** No
- **Authorized official:** Maria Carroll, SECRETARY
## Practice location
- **Address:** 550 MUNSON AVE, SUITE 200, Traverse City, MI 49686-3580
- **Phone:** (231) 935-8717 · **Fax:** (231) 935-9230
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** March 31, 2027 (Non-DME Part B, Michigan, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 3 clinicians (Dermatology) reassign Medicare billing to this organization (form CMS-855R); 3 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 28, 2015
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Source: [NPI Profile](https://npiprofile.com/npi/1952410094) · Data from the CMS NPPES public registry.