LYNN MARIE SQUANDA (DO) – Family Medicine Physician, NPI 1962437400

LYNN MARIE SQUANDA (DO) is a healthcare provider. based in Gaylord, Michigan. specializing in FAMILY PRACTICE. They hold the professional credentials DO. They hold a License No. 5101013512 (MI). The NPI Number for LYNN MARIE SQUANDA (DO) is 1962437400

Main info

Female
29 Years Of Experience
Accepts Medicare Assignment
Name
LYNN MARIE SQUANDA (DO)
NPI
1962437400
Phone
(989) 350-4105
Address
524 S COURT AVE
Enumeration Date
12 July 2006
Last Update Date
31 December 2024

Doctor Profile

Medical School Name
MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
9066325200
Graduation Year
1997 (29 years ago)
PAC ID
0840196903
Group Practice PAC ID
7012982937
Professional Enrollment ID
I20140624001037
Address ID
MI497833740SA2864XSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

4,418 FAMILY PRACTICE in MI

Provider Addresses for LYNN MARIE SQUANDA (DO)

  • 524 S COURT AVE

    GAYLORD, MI 497351215

    Phone: (989) 350-4105

    Type: Mailing

  • 1140 N STATE ST

    SAINT IGNACE, MI 497811048

    Phone: (906) 643-8689

    Fax: (906) 643-4165

    Type: Location

  • 3215, Dawn Drive, Midland, Midland County, Michigan, 48642, United States

    MIDLAND, MI 486424092

    Phone: (989) 350-4105

    Type: Mailing

  • 1523, South Mission Street, Mount Pleasant, Isabella County, Michigan, 48858, United States

    MOUNT PLEASANT, MI 488584230

    Phone: (989) 773-1166

    Fax: (989) 772-6835

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2003-12-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20031209001079IFamily PracticeMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49735)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7012982937View full group profile
NameSpecialtyState
-MI
Nurse PractitionerMI
Nurse PractitionerMI
Physician AssistantIL
Nurse PractitionerMI
Clinical Social WorkerMI
Nurse PractitionerMI
O P T O M E T R YMI
Clinical Social WorkerMI
-MI

Reviews

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Frequently asked questions

What federal number belongs to LYNN MARIE SQUANDA (DO)?
The federal identifier for LYNN MARIE SQUANDA (DO) is NPI 1962437400.
Is LYNN MARIE SQUANDA (DO) currently active in the NPI registry?
CMS-published data lists LYNN MARIE SQUANDA (DO) as an active registrant.
What kind of provider is LYNN MARIE SQUANDA (DO)?
The page reflects Family Medicine Physician for LYNN MARIE SQUANDA (DO). Clinical services aligned with this taxonomy classification.
What location metadata exists for LYNN MARIE SQUANDA (DO)?
The page summarizes Gaylord, Michigan for LYNN MARIE SQUANDA (DO); expand the address list for detail.
Is LYNN MARIE SQUANDA (DO) a real provider?
This page reflects official NPPES data for NPI 1962437400. Always confirm identity and privileges with the practice and licensing boards.

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