Birch Shore Primary Care PLLC
NPI 1396609467ActiveOrganization· Internal Medicine· Manistee, MI
Internal Medicine in Manistee, Michigan, registered in NPPES in December 2025, part of Northwoods Health Collective. The authorized official on file is Charles Jay Vandenberg, D.O., President. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1396609467 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Northwoods Health Collective |
| NPI issued | Dec 12, 2025 |
| Last updated in NPPES | May 27, 2026 |
| Certified by provider | May 27, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Internal Medicine Primary | 207R00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MI) |
|---|
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