NPIMap

Individual provider Active NPI

Dominic Pelle

  • Orthopaedic Surgery Physician
  • Grand Rapids, MI
National Provider Identifier
1184945453
Registry record updated Jun 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
4301096986 Issued in MI
Practice address
1000 Monroe Ave NW
Grand Rapids, MI 49503-1455
Phone
(616) 685-6497
Fax
(616) 685-3033
NPI assigned
Jun 21, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 4301096986 MI Primary

Addresses

Primary practice location

1000 Monroe Ave NW
Grand Rapids, MI 49503-1455

Mailing address

1000 Monroe Ave NW
Grand Rapids, MI 49503-1455
Phone (616) 685-6497

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160928000617 OH Practitioner - Orthopedic Surgery 3274770755 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Wayne State University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

6780 Mayfield Rd
Mayfield Heights, OH 44124-2203

8950 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-8950

9500 Euclid Ave
Cleveland, OH 44195-0001

Hospital & facility affiliations

  • Cleveland Clinic Home Care Home health agency, Independence, OH, CCN 367142
  • Cleveland Clinic Hospital, Cleveland, OH, CCN 360180
  • Hillcrest Hospital Hospital, Mayfield Heights, OH, CCN 360230
  • Marymount Hospital Hospital, Garfield Heights, OH, CCN 360143
  • Medina Hospital Hospital, Medina, OH, CCN 360091
  • Cleveland Clinic Avon Hospital Hospital, Avon, OH, CCN 360364

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion153
Laminectomy or laminotomy (partial removal of spine bones)40
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301096986MIMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Partners Physician Group CurrentSince Apr 9, 2018 Accepting new patients
Euclid Hospital Cleveland Clinic Health System Current Accepting new patients
The Cleveland Clinic Foundation CurrentSince Aug 2, 2016 Accepting new patients
The Metrohealth System Current Accepting new patients
Partners Physician Group Orthopaedic Surgery CurrentSince Apr 9, 2018 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

224 W Exchange St
Ste 225
Akron, OH 44302
Phone (330) 344-7400

4125 Medina Rd
Ste 200A
Akron, OH 44333
Phone (330) 665-0555

224 W Exchange St
Ste 160
Akron, OH 44302
Phone (330) 344-6505

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

Interoperability endpoints

  • Direct secure messaging: dpelle125920@direct.metrohealth.org
  • Direct secure messaging: dpelle377755@direct.ccf.org

Organizations & group practices 7

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.

Hospital & facility affiliations 6

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": "1277078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277078400000",
    "number": "1184945453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 MONROE AVE NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495031455",
            "telephone_number": "616-685-6497",
            "fax_number": "616-685-3033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MONROE AVE NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495031455",
            "telephone_number": "616-685-6497",
            "fax_number": "616-685-3033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLE",
        "first_name": "DOMINIC",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-21",
        "last_updated": "2010-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "4301096986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.