Crystal Lake Clinic P.C.
NPI 1376927756ActiveOrganization· Family Medicine· Traverse City, MI
Family Medicine in Traverse City, Michigan, registered in NPPES in July 2015. The authorized official on file is Richard C. Nielsen, M.D., President.
Overview
| NPI | 1376927756 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 15, 2015 |
| Last updated in NPPES | Jul 15, 2015 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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