Active NPI
Rubin Peter Gappy, MD
- Pediatrics Physician
- Saint Clair Shores, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 4301081978
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5315028539 | Other | MI | CONT SUB LICENSE |
| 4301081978 | Other | MI | PHYS 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301081978 | MI | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Henry Ford Cornerstone Medical Group | Current | 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
- rgappy1127548@direct.hfhs.org
- rubin.gappy.2@8209.direct.athenahealth.com
- 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.
-
- Family Medicine Physician
- Clinton Township, MI
- NPI 1851765374
-
dba Michigan Neuro-Ophthalmology & Oculoplastic Surgery
- Ophthalmology Physician
- Madison Heights, MI
- NPI 1114962461
-
- Pediatrics Physician
- Clinton Township, MI
- NPI 1497906499
-
dba St John Hospital and Medical Center
- General Acute Care Hospital
- Chicago, IL
- NPI 1023088168
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.