Crystal Lake Clinic Pc - Medicare Primary Care in Manistee, MI

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Crystal Lake Clinic Pc is a medicare enrolled primary clinic (Family Medicine) in Manistee, Michigan. The current practice location for Crystal Lake Clinic Pc is 1806 E Parkdale Ave Ste 2, Manistee, Michigan. For appointments, you can reach them via phone at (231) 882-9661. The mailing address for Crystal Lake Clinic Pc is 6227 Frankfort Hwy, Benzonia, Michigan and phone number is (231) 882-9661.

Crystal Lake Clinic Pc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1134491731. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (231) 882-9661.

Contact Information

Crystal Lake Clinic Pc
1806 E Parkdale Ave Ste 2
Manistee
MI 49660-9364
(231) 882-9661
Not Available

Map and Direction


Primary Care Clinic Profile

Full NameCrystal Lake Clinic Pc
SpecialityFamily Medicine
Location1806 E Parkdale Ave Ste 2, Manistee, Michigan
Authorized Official Name and PositionRichard Nielsen (PRESIDENT)
Authorized Official Contact2318829661
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Crystal Lake Clinic Pc
6227 Frankfort Hwy
Benzonia
MI 49616-8632

Ph: (231) 882-9661		Crystal Lake Clinic Pc
1806 E Parkdale Ave Ste 2
Manistee
MI 49660-9364

Ph: (231) 882-9661

NPI Details:

NPI Number1134491731
Provider Enumeration Date01/30/2012
Last Update Date01/30/2012

Medicare PECOS Information:

Medicare PECOS PAC ID0648259010
Medicare Enrollment IDO20040802000634

Medical Identifiers

Medical identifiers for Crystal Lake Clinic Pc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1134491731NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Crystal Lake Clinic Pc acts as a billing entity for following providers:
Provider NameGerard Mahoney
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1659385219
PECOS PAC ID: 3274428909
Enrollment ID: I20040220000080
Provider NameCarol King
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1629046297
PECOS PAC ID: 2466436928
Enrollment ID: I20040614001424
Provider NameMaureen Reynolds Street
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1093716052
PECOS PAC ID: 1557327038
Enrollment ID: I20041207000122
Provider NameMark A Priest
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1720157688
PECOS PAC ID: 0042277840
Enrollment ID: I20041215000296
Provider NameMichael F Carroll
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1346338324
PECOS PAC ID: 5092764399
Enrollment ID: I20050118000633
Provider NameRyan A Sullivan
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1174605653
PECOS PAC ID: 0547292294
Enrollment ID: I20050906000090
Provider NameGlenn Griffiths
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1932199965
PECOS PAC ID: 3173601770
Enrollment ID: I20080423000145
Provider NameMaxine A Lipon
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1598984387
PECOS PAC ID: 3779640453
Enrollment ID: I20090331000431
Provider NameGeorge B Ryckman
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1023032380
PECOS PAC ID: 2961481346
Enrollment ID: I20101007000224
Provider NameJennifer K Gilbert
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1477820983
PECOS PAC ID: 5294984225
Enrollment ID: I20121005000432
Provider NameJacob Flynn
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1104114230
PECOS PAC ID: 7315162948
Enrollment ID: I20140715001549
Provider NameMatthew R Jackson
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1588897896
PECOS PAC ID: 5597994087
Enrollment ID: I20140818002073
Provider NameAnna Cox
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1568842052
PECOS PAC ID: 3678887601
Enrollment ID: I20150804004041
Provider NameDanielle Koch
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1275771370
PECOS PAC ID: 8022316777
Enrollment ID: I20170523002170
Provider NameNancy Dorman
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1750801940
PECOS PAC ID: 9234401613
Enrollment ID: I20170818002861
Provider NameBecky Lynn Porter
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1811400302
PECOS PAC ID: 5294091666
Enrollment ID: I20171117002502
Provider NameHeather Morgan Sedgwick
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1598251589
PECOS PAC ID: 1254680820
Enrollment ID: I20180815003546
Provider NameHeidi Collins
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1336606078
PECOS PAC ID: 5395086292
Enrollment ID: I20190402002038
Provider NameAnna L Mapes
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1053910703
PECOS PAC ID: 4082026331
Enrollment ID: I20201210002415
Provider NameAshley Marie Goss
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1306432059
PECOS PAC ID: 3476969247
Enrollment ID: I20210303001793
Provider NameAmanda M Smith
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1740773456
PECOS PAC ID: 8022412923
Enrollment ID: I20210813000583
Provider NameWilliam David James
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1851754865
PECOS PAC ID: 9739586694
Enrollment ID: I20210921001254
Provider NameAmanda Deering
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1164180642
PECOS PAC ID: 5698167336
Enrollment ID: I20220110001225
Provider NameDenielle Bohland
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1306507363
PECOS PAC ID: 8921492372
Enrollment ID: I20220228002632
Provider NameCharone Sexton
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1083344980
PECOS PAC ID: 0446631915
Enrollment ID: I20220714001413
Provider NameDavid Kamp
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1982326468
PECOS PAC ID: 6103292891
Enrollment ID: I20221020002759

Reviews and Comments


Family Medicine in Manistee, MI

Indigo Hospital Medicine - Manistee, Plc
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Medicare: Not Enrolled in Medicare
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Phone: 231-346-6807    
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Phone: 231-398-1750    Fax: 231-398-1751
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Harmony Health Family Practice
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Practice Location: 50 Filer St Ste 324, Manistee, MI 49660
Phone: 231-887-4129    Fax: 231-887-4324
Manistee Family Health Care Plc
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 110 Washington St, Manistee, MI 49660
Phone: 231-723-9190    Fax: 231-723-9191
Northwest Michigan Health Services, Inc.
Primary Care Clinic
Medicare: Medicare Enrolled
Practice Location: 148 W Parkdale Ave, Manistee, MI 49660
Phone: 231-947-0351    Fax: 231-947-7739

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.