Individual provider Active NPI

Rubin Peter Gappy, MD

  • Pediatrics Physician
  • Saint Clair Shores, MI
National Provider Identifier
1003825894
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301081978 Issued in MI
Practice address
20225 E 9 Mile Rd
Suite a
Saint Clair Shores, MI 48080-1775
Phone
(586) 772-1090
Fax
(586) 772-4366
NPI assigned
Aug 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301081978 MI Primary

Addresses

Primary practice location

20225 E 9 Mile Rd
Suite a
Saint Clair Shores, MI 48080-1775

Mailing address

46591 Romeo Plank Rd
Suite 205
Macomb, MI 48044-5742
Phone (586) 226-6252

Other identifiers 2

IdentifierTypeStateIssuer
5315028539OtherMICONT SUB LICENSE
4301081978OtherMIPHYS LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210408001551 MI Practitioner - Pediatric Medicine 7416365507 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301081978MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Cornerstone Medical Group CurrentSince Jan 1, 2021 Accepting new patients
Henry Ford Health St. John Hospital Past Accepting new patients
Thomas D Schomaker DO PC Pediatrics Past Accepting new patients
Ascension Macomb Oakland Hospital Past Accepting new patients

Locations

43900 Garfield Rd
Ste 222
Clinton Twp, MI 48038
Phone (586) 263-1234

36075 Utica Rd
Ste 100
Clinton Twp, MI 48035
Phone (586) 741-0430

46591 Romeo Plank Rd
Ste 205
Macomb, MI 48044
Phone (586) 226-6250

46591 Romeo Plank Rd
Ste 112
Macomb, MI 48044
Phone (586) 228-0130

1135 W University Dr
Ste 355
Rochester Hills, MI 48307
Phone (248) 680-8060

25319 Little Mack Ave
Ste 100
Saint Clair Shores, MI 48081

20225 E 9 Mile Rd
Ste A
St Clr Shores, MI 48080
Phone (586) 772-1090

Interoperability endpoints

  • Direct secure messaging: rgappy1127548@direct.hfhs.org
  • Direct secure messaging: rubin.gappy.2@8209.direct.athenahealth.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/mQjCqHb5rkr1u1foU4dqhQPBpi7Qk9R4/

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003825894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46591 ROMEO PLANK RD",
            "address_2": "SUITE 205",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480445742",
            "telephone_number": "586-226-6252",
            "fax_number": "586-226-6255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20225 E 9 MILE RD",
            "address_2": "SUITE A",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801775",
            "telephone_number": "586-772-1090",
            "fax_number": "586-772-4366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAPPY",
        "first_name": "RUBIN",
        "middle_name": "PETER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301081978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONT SUB LICENSE",
            "identifier": "5315028539",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYS LICENSE",
            "identifier": "4301081978",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.