Individual provider Active NPI

Peter A Kovalszki, MD

  • Specialist
  • Mount Clemens, MI
National Provider Identifier
1114924248
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
4301052134 Issued in MI
Practice address
133 S Main St
Suite D
Mount Clemens, MI 48043-2308
Phone
(586) 465-1326
Fax
(586) 465-0329
NPI assigned
Jul 5, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 4301052134 MI Primary

Addresses

Primary practice location

133 S Main St
Suite D
Mount Clemens, MI 48043-2308

Mailing address

133 S Main St
Suite D
Mount Clemens, MI 48043-2308
Phone (586) 465-1326

Other identifiers 1

IdentifierTypeStateIssuer
267880MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine Associates of Mt. Clemens, PC CurrentSince Sep 30, 1996 Accepting new patients
Henry Ford Macomb Ancillary Services Current Accepting new patients
Center for Weight Management Specialist Past Accepting new patients

Locations

15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2300

133 S Main St
Mount Clemens, MI 48043
Phone (586) 329-1880

133 S Main St
Ste D
Mount Clemens, MI 48043
Phone (313) 465-1326

215 North Ave
Mount Clemens, MI 48043
Phone (586) 307-9010

38600 Van Dyke Ave
Ste 255
Sterling Heights, MI 48312
Phone (586) 978-2222

Interoperability endpoints

  • Direct secure messaging: pkovakski240427@direct.hfhs.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1114924248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 S MAIN ST",
            "address_2": "SUITE D",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432308",
            "telephone_number": "586-465-1326",
            "fax_number": "586-465-0329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 S MAIN ST",
            "address_2": "SUITE D",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432308",
            "telephone_number": "586-465-1326",
            "fax_number": "586-465-0329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVALSZKI",
        "first_name": "PETER",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MI",
            "license": "4301052134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "267880",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Clemens, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.