Individual provider Active NPI

Pano L Papalekas, MD

  • Physical Medicine & Rehabilitation Physician
  • Saint Clair Shores, MI
National Provider Identifier
1174517304
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
4301059548 Issued in MI
Practice address
25311 Little Mack
Ste B
St Clair Shores, MI 48081
Phone
(586) 498-5400
Fax
(586) 498-2800
NPI assigned
Sep 2, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 4301059548 MI Primary

Addresses

Primary practice location

25311 Little Mack
Ste B
St Clair Shores, MI 48081

Mailing address

25311 Little Mack
Ste B
St Clair Shores, MI 48081
Phone (586) 498-5400

Other identifiers 1

IdentifierTypeStateIssuer
4301059548OtherMIMICHIGAN LICENSE

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
I20040329001499 MI Practitioner - Physical Medicine and Rehabilitation 0749170900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Medical College of Ohio, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
VHS Physicians of MichiganGroup PAC ID 8921289760, 219 clinicians

Practice addresses (Care Compare)

1 Wiliam Carls Dr
Commerce Township, MI 48382-2201

261 Mack Ave
Detroit, MI 48201-2417

3901 Beaubien 1St Floor
Detroit, MI 48201-2119
Phone (313) 745-5227

3901 Beaubien St
Detroit, MI 48201-2119

3990 John R St
Detroit, MI 48201-2018

4100 John R St
Detroit, MI 48201-2013
Phone (800) 527-6266

4123 Martin Rd
Suite 102
Commerce Township, MI 48390-4151
Phone (248) 366-3700

4201 Saint Antoine St
Detroit, MI 48201-2153

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.26 of 100Reported as group
Quality
64.16
Promoting interoperability
100
Improvement activities
40
Cost
73.79

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301059548MIMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
VHS Physicians of Michigan CurrentSince Sep 30, 2011 Accepting new patients
Great Lakes Physiatrists PC Physical Medicine & Rehabilitation PastSince Oct 1, 1990 Accepting new patients

Locations

261 Mack Ave
Detroit, MI 48201
Phone (313) 745-1100

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

Interoperability endpoints

  • Direct secure messaging: ppapalek@direct.dmc.org
  • Direct secure messaging: ppapalekas233752@direct.hfhs.org

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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": "1125619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174517304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25311 LITTLE MACK",
            "address_2": "STE B",
            "city": "ST CLAIR SHORES",
            "state": "MI",
            "postal_code": "48081",
            "telephone_number": "586-498-5400",
            "fax_number": "586-498-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25311 LITTLE MACK",
            "address_2": "STE B",
            "city": "ST CLAIR SHORES",
            "state": "MI",
            "postal_code": "48081",
            "telephone_number": "586-498-5400",
            "fax_number": "586-498-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAPALEKAS",
        "first_name": "PANO",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "4301059548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN LICENSE",
            "identifier": "4301059548",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.