Stephen L Peck, M.D.

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

4301038298 Issued in MI

Practice address

1717 Shaffer St
Suite 232
Kalamazoo, MI 49048-1647

Phone

(269) 226-5050

Fax

(269) 226-5034

NPI assigned

Sep 22, 2006

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

Other identifiers 4

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

Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)

Education

Wayne State University School of Medicine, 1976

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ascension Medical Group PromedGroup PAC ID 7315856077, 255 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Borgess Medical Center Hospital, Kalamazoo, MI, CCN 230117
• Bronson Battle Creek Hospital Hospital, Battle Creek, MI, CCN 230075
• Bronson Methodist Hospital Hospital, Kalamazoo, MI, CCN 230017
• Oaklawn Hospital Hospital, Marshall, MI, CCN 230217
• Three Rivers Health Hospital, Three Rivers, MI, CCN 230015
• Beacon Plainwell Long-term care hospital, Plainwell, MI, CCN 232034

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Ascension Medical Group Promed

  • Family Medicine Physician
  • Portage, MI
  • NPI 1497709869

  Cardiovascular Disease

  Medicare reassignment Care Compare group NPD
• Ascension Borgess Hospital

  • General Acute Care Hospital
  • Kalamazoo, MI
  • NPI 1568416311
  Medicare reassignment NPD
• Kalamazoo Cardiology PC

  • Cardiovascular Disease Physician
  • Kalamazoo, MI
  • NPI 1407955453
  NPD (past) Authorized official
• Ascension Borgess Hospital

  • Cardiovascular Disease Physician
  • Kalamazoo, MI
  • NPI 1306976204
  NPD
• Ascension Borgess Hospital

  • Diagnostic Radiology Physician
  • Kalamazoo, MI
  • NPI 1518753441
  NPD
• Ascension Medical Group Promed

  • Internal Medicine Physician
  • Kalamazoo, MI
  • NPI 1720009954

  Cardiovascular Disease

  NPD
• Promed Healthcare

  • Rural Health Clinic/Center
  • Plainwell, MI
  • NPI 1487708830
  NPD

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

• Ascension Borgess Hospital

  • Long Term Care Hospital
  • Plainwell, MI
  • NPI 1154504892

  Long-term care hospital

  Care Compare affiliation
• Ascension Borgess Hospital

  • General Acute Care Hospital
  • Kalamazoo, MI
  • NPI 1568416311
  Care Compare affiliation
• Bronson Battle Creek Hospital

  • General Acute Care Hospital
  • Battle Creek, MI
  • NPI 1083644579
  Care Compare affiliation
• Bronson Methodist Hospital

  • General Acute Care Hospital
  • Kalamazoo, MI
  • NPI 1831116441
  Care Compare affiliation
• Ella E. M. Brown Charitable Circle

  • General Acute Care Hospital
  • Marshall, MI
  • NPI 1861475360
  Care Compare affiliation
• Three Rivers Health System, Inc

  • General Acute Care Hospital
  • Three Rivers, MI
  • NPI 1568739423
  Care Compare affiliation

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433980800000",
    "number": "1124127162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 SHAFFER ST",
            "address_2": "SUITE 232",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481647",
            "telephone_number": "269-226-5050",
            "fax_number": "269-226-5034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 SHAFFER ST",
            "address_2": "SUITE 232",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481647",
            "telephone_number": "269-226-5050",
            "fax_number": "269-226-5034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "STEPHEN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2015-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301038298",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MI",
            "license": "4301038298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP/IBA",
            "identifier": "25-31067",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "SP038298",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN",
            "identifier": "P54643",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1394115",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Holly Patricia Pearson
• Jeffrey P. Pearson, M.D.
• Kristy Pearson
• Roberta Pearson, RPH
• Dustin Daniel Peck, LMSW
• Lukas Lee Pederson, LPC
• Pediatric Counseling Center, LLC
• Sierra Pedraja
• Brycen Wade Peebles
• Andrew Peekstok

• Interventional Cardiology Physician in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Interventional Cardiology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2015; 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.