Peter S Vasiu DO PC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

5101012366 Issued in MI

Legal business name

PETER S VASIU DO PC

Practice address

2591 44TH St SE
Suite 103
Kentwood, MI 49512-9094

Phone

(616) 281-7000

NPI assigned

Apr 17, 2008

Last updated

Oct 7, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Amy J Degood

Title

Office Manager

Phone

(616) 281-7000

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI2 enrollments

Enrollment records 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Peter S Vasiu, DO

  • Orthopaedic Surgery Physician
  • Grand Rapids, MI
  • NPI 1881675429
  Medicare reassignment NPD

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

{
    "created_epoch": "1208390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286409600000",
    "number": "1184898454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2591 44TH ST SE",
            "address_2": "SUITE 103",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495129094",
            "telephone_number": "616-281-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2591 44TH ST SE",
            "address_2": "SUITE 103",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495129094",
            "telephone_number": "616-281-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER S VASIU DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-17",
        "last_updated": "2010-10-07",
        "status": "A",
        "authorized_official_last_name": "DEGOOD",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "616-281-7000",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "5101012366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "2054102165",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4521418",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Josh Pelton, BCBA
• Nichole Lynn Penny, R.PH.
• Perry Drug Stores Inc and Subsidiaries (Rite Aid Pharmacy 04395)
• Kassandra Peruski, PHARM.D.
• Elizabeth Peshia, RD
• Debra Ann Peters, LMSW, LPC
• Emma McKeown Peterson
• Kristen Linley Pfeiffer, PA-C
• David M Phillips, DDS
• Ricky Joe Phillips, PH.D., LCC

• Orthopaedic Surgery Physician in Kentwood, MI
• Providers in Kentwood, MI by specialty
• Orthopaedic Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.