NPIMap

Individual provider Active NPI

Peter M Nefcy, M.D., PHD

  • Nuclear Radiology Physician
  • Warren, MI
National Provider Identifier
1164414165
Registry record updated Apr 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nuclear Radiology PhysicianTaxonomy code 2085N0904X
License
4301046061 Issued in MI
Practice address
11012 E 13 Mile Rd
Suite 111
Warren, MI 48093-2572
Phone
(586) 558-8470
Fax
(586) 558-8481
NPI assigned
Aug 17, 2005
Last updated
Apr 18, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Radiology Physician 2085N0904X 4301046061 MI Primary

Addresses

Primary practice location

11012 E 13 Mile Rd
Suite 111
Warren, MI 48093-2572

Mailing address

29900 Lorraine Ave
Suite 400
Warren, MI 48093-5266
Phone (586) 582-0864

Other identifiers 5

IdentifierTypeStateIssuer
4390361MedicaidMI
4484388MedicaidMI
700F340300OtherMIBCBS
700E021910OtherMIBCBS
700E021830OtherMIBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, CT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040501000027 MI Practitioner - Diagnostic Radiology 5597753442 Reassigns benefits to 6 organizations
I20260504008119 CT Practitioner - Diagnostic Radiology 5597753442 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Basha Diagnostics P CGroup PAC ID 5890681746, 28 clinicians
Michigan Neurology Associates PCGroup PAC ID 8628987468, 18 clinicians
Riverside Radiology and Interventional Associates IncGroup PAC ID 8729976964, 251 clinicians

Practice addresses (Care Compare)

114 Woodland St
Hartford, CT 06105-1208
Phone (860) 714-4000

30701 Woodward Ave
Suite LL
Royal Oak, MI 48073-0988
Phone (248) 288-1600

34025 Harper Ave
Clinton Township, MI 48035-3737
Phone (586) 445-9900

3965 Chestnut Hill CT
Troy, MI 48084-1041
Phone (614) 340-7740

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Radiology and Interventional Associates Inc CurrentSince Jan 1, 2022 Accepting new patients
Omic LLC CurrentSince Jan 1, 2022 Accepting new patients
Radadvantage a Professional Corporation CurrentSince Dec 1, 2018 Accepting new patients
Michigan Neurology Associates, P.C. CurrentSince Apr 1, 2008 Accepting new patients
Lucidsolutions, Inc. Nuclear Radiology CurrentSince Jan 1, 2022 Accepting new patients
Basha Diagnostics P C CurrentSince Apr 1, 2018 Accepting new patients
Madison Medical Center Past Accepting new patients
Son-X P.C. Past Accepting new patients
Son-X Imaging Inc. Past Accepting new patients
Tricity Medical Centers, P.C. Past Accepting new patients

Locations

34025 Harper Ave
Clinton Twp, MI 48035
Phone (586) 445-9900

1 William Carls Dr
Commerce Twp, MI 48382
Phone (248) 227-5500

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

4201 Saint Antoine St
Detroit, MI 48201
Phone (313) 745-3615

30701 Woodward Ave
Ste Ll
Royal Oak, MI 48073
Phone (248) 288-1600

19699 E 8 Mile Rd
St Clr Shores, MI 48080
Phone (586) 445-9900

5119 Rochester Rd
Troy, MI 48085
Phone (248) 740-0777

Interoperability endpoints

  • Direct secure messaging: michiganneurologyassociates.peternefcy@158246.advancedmd-direct.com

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366243200000",
    "number": "1164414165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29900 LORRAINE AVE",
            "address_2": "SUITE 400",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480935266",
            "telephone_number": "586-582-0864",
            "fax_number": "586-582-0964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11012 E 13 MILE RD",
            "address_2": "SUITE 111",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480932572",
            "telephone_number": "586-558-8470",
            "fax_number": "586-558-8481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEFCY",
        "first_name": "PETER",
        "middle_name": "M",
        "credential": "M.D., PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-17",
        "last_updated": "2013-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "MI",
            "license": "4301046061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4390361",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4484388",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "700F340300",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "700E021910",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "700E021830",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.