Individual provider Active NPI

Peter Flynn Sarnacki I, DO

  • Neurology with Special Qualifications in Child Neurology Physician
  • Cleveland, OH
National Provider Identifier
1053930198
Registry record updated Mar 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
5101029188 Issued in MI
Practice address
Cleveland Clinic 9500 Euclid Avenue/NA-23
Cleveland, OH 44195-0001
Phone
(216) 444-2200
NPI assigned
Apr 9, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 5101029188 MI Primary

Addresses

Primary practice location

Cleveland Clinic 9500 Euclid Avenue/NA-23
Cleveland, OH 44195-0001

Mailing address

804 Service Rd
East Lansing, MI 48824-7015
Phone (216) 444-2200

Other practice location 1

804 Service Rd Ste A217
East Lansing, MI 48824-7015
Phone (517) 353-8122

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
I20260422000253 MI Practitioner - NeurologyPractitioner - Psychiatry 1658701057 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Psychiatry
Education
Michigan State University College of Human Medicine, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

804 Service Rd
East Lansing, MI 48824-7015

8175 Reliable Pkwy
Chicago, IL 60686-0081

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101029188MIMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Msu Health Care Inc. Neurology With Special Qualifications in Child Neurology Past Accepting new patients
Msu Health Care Inc Neurology With Special Qualifications in Child Neurology Past Accepting new patients

Organizations & group practices 3

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": "1586390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773964800000",
    "number": "1053930198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SERVICE RD",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488247015",
            "telephone_number": "216-444-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CLEVELAND CLINIC 9500 EUCLID AVENUE/NA-23",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001",
            "telephone_number": "216-444-2200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "804 Service Rd Ste A217",
            "address_purpose": "LOCATION",
            "city": "East Lansing",
            "state": "MI",
            "postal_code": "488247015",
            "country_code": "US",
            "telephone_number": "517-353-8122",
            "fax_number": "517-432-3713",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SARNACKI",
        "first_name": "PETER",
        "middle_name": "FLYNN",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-09",
        "last_updated": "2026-03-20",
        "certification_date": "2026-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "MI",
            "license": "5101029188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.