ALPINE FAMILY MEDICINE PLC – Family Medicine Physician, NPI 1174577720

ALPINE FAMILY MEDICINE PLC is a healthcare provider. based in Gaylord, Michigan. specializing in Family Medicine Physician. The organization holds a License No. KK030249 (MI). The NPI Number for ALPINE FAMILY MEDICINE PLC is 1174577720

Main info

Organization
Name
ALPINE FAMILY MEDICINE PLC
NPI
1174577720
Phone
(989) 732-3529
Address
652 N OTSEGO AVE
Authorized Official
DR. DEREK DAVID OLSON MD/OWNER MD
Enumeration Date
19 May 2006
Last Update Date
6 January 2021

Contacts

Secure Messaging
derek-olson@alpinefamilymedicine.e-mdsdirect.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness85
Years active:20State licenses:1Other namesUpdated within 12 months

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Provider Addresses for ALPINE FAMILY MEDICINE PLC

  • 652, North Otsego Avenue, Gaylord, Otsego County, Michigan, 49735, United States

    GAYLORD, MI 497352502

    Phone: (989) 732-3529

    Fax: (989) 732-7865

    Mailing address matches the actual address.

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: 2004-10-28

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Revalidation scheduled

Earliest CMS due date is 2026-09-30 (112 days away).

Enrollment records

1

Earliest due date

2026-09-30

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
O20041028000119OClinic/Group PracticeMI2026-09-30

What to do next

  • Monitor the published due date as it approaches.
  • Plan to revalidate in PECOS within the window CMS allows before the due date.
  • Verify the date on the CMS Revalidation Lookup Tool before submitting.

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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Reviews

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Frequently asked questions

Does ALPINE FAMILY MEDICINE PLC share an NPI with anyone else?
NPI numbers are unique to each provider or organization — ALPINE FAMILY MEDICINE PLC uses 1174577720.
Does CMS list ALPINE FAMILY MEDICINE PLC as active?
Yes — ALPINE FAMILY MEDICINE PLC is active in the NPI listing used on this page.
What is ALPINE FAMILY MEDICINE PLC's primary classification?
Family Medicine Physician is the headline specialty for ALPINE FAMILY MEDICINE PLC here. Clinical services aligned with this taxonomy classification.
What address line appears for ALPINE FAMILY MEDICINE PLC?
ALPINE FAMILY MEDICINE PLC's geographic hint is Gaylord, Michigan in our summary view.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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