Michael Douglas Peacock, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

4301096679 Issued in MI

Practice address

1500 E. Medical Center Drive
B1-380 TC
Ann Arbor, MI 48109-5305

Phone

(734) 763-7919

Fax

(734) 763-9298

NPI assigned

May 28, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Emergency Medicine

Education

Michigan State University College of Human Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hawk Emergency Group, P.C.Group PAC ID 6800241050, 55 clinicians

Caberfae Emergency Group PCGroup PAC ID 4082069232, 39 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Munson Healthcare Grayling Hospital Hospital, Grayling, MI, CCN 230058
• Munson Healthcare Cadillac Hospital Hospital, Cadillac, MI, CCN 230081
• Charlevoix Area Hospital Hospital, Charlevoix, MI, CCN 231322

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Caberfae Emergency Group, P.C.

  • Emergency Medicine Physician
  • Cadillac, MI
  • NPI 1447932504

  Emergency Medicine, MI

  Medicare reassignment Care Compare group NPD
• Hawk Emergency Group, P.C.

  • Emergency Medicine Physician
  • Charlevoix, MI
  • NPI 1073295135

  Emergency Medicine, MI

  Medicare reassignment Care Compare group NPD
• Kalkaska Memorial Health Center

  • Family Medicine Physician
  • Kalkaska, MI
  • NPI 1013183060

  Emergency Medicine, MI

  Medicare reassignment NPD
• Munson Healthcare Cadillac

  • Rural Health Clinic/Center
  • MC Bain, MI
  • NPI 1336539063

  MI

  Medicare reassignment NPD
• Kalkaska Memorial Health Center

  • Skilled Nursing Facility
  • Kalkaska, MI
  • NPI 1164386652
  NPD
• Munson Healthcare Cadillac

  • Psychiatry Physician
  • Traverse City, MI
  • NPI 1720955081
  NPD
• Munson Healthcare Cadillac

  • Family Medicine Physician
  • Cadillac, MI
  • NPI 1750871117
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Munson Healthcare Cadillac

  • Family Medicine Physician
  • Cadillac, MI
  • NPI 1487051611

  Hospital

  Care Compare affiliation
• Munson Healthcare Cadillac

  • General Acute Care Hospital
  • Cadillac, MI
  • NPI 1841696754

  Hospital

  Care Compare affiliation
• Munson Healthcare Charlevoix Hospital

  • Critical Access Hospital
  • Charlevoix, MI
  • NPI 1346260692

  Hospital

  Care Compare affiliation
• Munson Healthcare Grayling

  • Rural Acute Care Hospital
  • Grayling, MI
  • NPI 1083010953

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1275004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377129600000",
    "number": "1104145200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 E. MEDICAL CENTER DRIVE",
            "address_2": "B1-380 TC",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095305",
            "telephone_number": "734-763-7919",
            "fax_number": "734-763-9298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E. MEDICAL CENTER DRIVE",
            "address_2": "B1-380 TC",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095305",
            "telephone_number": "734-763-7919",
            "fax_number": "734-763-9298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEACOCK",
        "first_name": "MICHAEL",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-28",
        "last_updated": "2013-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301096679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zoe Payne, BSN, RN
• Paul Stephen Pazdalski, MD
• Jessica Katherine Pazur, NP
• Megan Visotski Peace, PA-C
• Peaceful Psyche LLC
• Bridget K Pearce, MD
• Pearle Vision Inc
• Pearle Vision Inc
• Pearle Vision Inc
• Pearle Vision Inc

• All providers in Ann Arbor, MI
• Emergency Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.