NORTHWESTERN MICHIGAN DERMATOLOGY PC
NPI 1952410094
Dermatology in Traverse City, MI

NPI Status: Active since August 30, 2006

Contact Information

550 MUNSON AVE
SUITE 200
TRAVERSE CITY, MI
ZIP 49686
Phone: (231) 935-8717
Fax: (231) 935-9230

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  • Organization
  • Dermatology
  • Accepts Insurance
  • CLIA Number: 23D0381425
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 12-07-2025

About NORTHWESTERN MICHIGAN DERMATOLOGY PC

This page provides the complete NPI Profile along with additional information for Northwestern Michigan Dermatology Pc, a provider established in Traverse City, Michigan operating as a Dermatology. The healthcare provider is registered in the NPI registry with number 1952410094 assigned on August 2006. The practitioner's primary taxonomy code is 207N00000X. The provider is registered as an organization and their NPI record was last updated 11 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Maria C Carroll M.d. (Secretary)

NPI
1952410094
Provider Name
NORTHWESTERN MICHIGAN DERMATOLOGY PC
Entity Type
Organization
Location Address
550 MUNSON AVE SUITE 200 TRAVERSE CITY, MI 49686
Location Phone
(231) 935-8717
Location Fax
(231) 935-9230
Mailing Address
550 MUNSON AVE SUITE 200 TRAVERSE CITY, MI 49686
Mailing Phone
(231) 935-8717
Mailing Fax
(231) 935-9230
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
08-30-2006
Last Update Date
09-28-2015
Code Navigator

A dermatologist like Northwestern Michigan Dermatology Pc is a medical specialty involving the management of skin conditions and diseases. Dermatologists diagnose some sexually transmitted diseases, warts, cancer, acne, dermatitis and may offer cosmetic treatments, and therapies that reduce age spots and wrinkles.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Dermatology

Taxonomy Code
207N00000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Blue Cross� Preferred HMO Bronze Extra - HMO
  • Blue Cross� Preferred HMO Bronze Saver HSA - HMO
  • Blue Cross� Preferred HMO Bronze Secure - HMO
  • Blue Cross� Preferred HMO Gold - HMO
  • Blue Cross� Preferred HMO Gold Extra - HMO
  • Blue Cross� Preferred HMO Silver - HMO
  • Blue Cross� Preferred HMO Silver Extra - HMO
  • Blue Cross� Preferred HMO Silver Saver - HMO
  • Blue Cross� Preferred HMO Value - HMO
  • Blue Cross� Select HMO Bronze Extra - HMO
  • Blue Cross� Select HMO Bronze Saver HSA - HMO
  • Blue Cross� Select HMO Bronze Secure - HMO
  • Blue Cross� Select HMO Silver - HMO
  • Blue Cross� Select HMO Silver Extra - HMO
  • Blue Cross� Select HMO Silver Saver - HMO
  • Blue Cross� Select HMO Value - HMO
  • Blue Cross� Premier PPO Bronze Extra - PPO
  • Blue Cross� Premier PPO Bronze Saver HSA - PPO
  • Blue Cross� Premier PPO Bronze Secure - PPO
  • Blue Cross� Premier PPO Gold - PPO
  • Blue Cross� Premier PPO Gold Extra - PPO
  • Blue Cross� Premier PPO Silver - PPO
  • Blue Cross� Premier PPO Silver Extra - PPO
  • Blue Cross� Premier PPO Silver Saver HSA - PPO
  • Blue Cross� Premier PPO Value - PPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MARIA C CARROLL M.D.

Authorized Official Title
SECRETARY
Authorized Official Phone
(231) 935-8717

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
23D0381425
Facility Type
Physician Office
Certificate Effective Date
December 08, 2023
Certificate Expiration Date
December 07, 2025
Laboratory Director
MARK R. POMARANSKI
Certificate Type
Certificate of Compliance
Certificate Type Description
This CLIA certificate is issued to Northwestern Michigan Dermatology Pc after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1952410094, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 56. The final step is to find the difference between that total and the next multiple of ten (60 - 56 = 4).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
9
Unchanged
Pos 3
5
Doubled → 10 → 1 + 0
Pos 4
2
Unchanged
Pos 5
4
Doubled → 8
Pos 6
1
Unchanged
Pos 7
0
Doubled → 0
Pos 8
0
Unchanged
Pos 9
9
Doubled → 18 → 1 + 8
Check
4
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 5 → 10 → 1 4 → 8 0 → 0 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 9 + 1 + 0 + 2 + 8 + 1 + 0 + 0 + 1 + 8 + 24 = 56

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 56 is 60. The difference is the calculated check digit.

60 - 56 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1952410094.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Pharmacist (Geriatric)
550 MUNSON AVE
TRAVERSE CITY, MI 49686
Specialist/Technologist (Athletic Trainer)
550 MUNSON AVE, MCHC OUTPATIENT REHAB
TRAVERSE CITY, MI 49686
Pharmacist
550 MUNSON AVE, SUITE G-100
TRAVERSE CITY, MI 49686
Pharmacist
550 MUNSON AVE, SUITE G100
TRAVERSE CITY, MI 49686
Pharmacist
550 MUNSON AVE, SUITE G100
TRAVERSE CITY, MI 49686
Internal Medicine (Pulmonary Disease)
550 MUNSON AVE, SUITE 202
TRAVERSE CITY, MI 49686
Family Medicine
550 MUNSON AVE
TRAVERSE CITY, MI 49686
Emergency Medicine
550 MUNSON AVE
TRAVERSE CITY, MI 49686
General Practice
550 MUNSON AVE
TRAVERSE CITY, MI 49686
Emergency Medicine
550 MUNSON AVE
TRAVERSE CITY, MI 49686
Physician Assistant
550 MUNSON AVE
TRAVERSE CITY, MI 49686
Physician Assistant
550 MUNSON AVE
TRAVERSE CITY, MI 49686
Preventive Medicine (Occupational Medicine)
550 MUNSON AVE
TRAVERSE CITY, MI 49686
Preventive Medicine (Occupational Medicine)
550 MUNSON AVE
TRAVERSE CITY, MI 49686
Pharmacist
550 MUNSON AVE, SUITE G-100
TRAVERSE CITY, MI 49686
Physician Assistant
550 MUNSON AVE
TRAVERSE CITY, MI 49686
Physician Assistant
550 MUNSON AVE
TRAVERSE CITY, MI 49686
Pharmacist
550 MUNSON AVE, SUITE G100
TRAVERSE CITY, MI 49686
Psychologist
550 MUNSON AVE
TRAVERSE CITY, MI 49686
Specialist/Technologist (Athletic Trainer)
550 MUNSON AVE
TRAVERSE CITY, MI 49686

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1952410094, enumerated as an "organization" on August 30, 2006.

The provider is located at 550 MUNSON AVE SUITE 200 TRAVERSE CITY, MI 49686 and the phone number is (231) 935-8717.

Dermatology with taxonomy code 207N00000X.

The provider might be accepting Accepts: Blue Care Network of Michigan and Blue Cross Blue. Please consult your insurance carrier or call the provider to verify.