Individual provider Active NPI

Jennifer Hung-Wen Peng, M.D.

  • Obstetrics & Gynecology Physician
  • Sterling Heights, MI
National Provider Identifier
1245593359
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
4301101454 Issued in MI
Practice address
44250 Dequindre Rd
Sterling Heights, MI 48314-1002
Phone
(248) 964-0400
Fax
(248) 964-0401
NPI assigned
Jun 22, 2012
Last updated
Aug 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 4301101454 MI Primary

Addresses

Primary practice location

44250 Dequindre Rd
Sterling Heights, MI 48314-1002

Mailing address

26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849
Phone (947) 522-1865

Other practice location 1

3290 W. Big Beaver
Suite 444
Troy, MI 48084-2914
Phone (248) 816-9200

Other practice location 2

44201 Dequindre Rd
Troy, MI 48085-1117
Phone (248) 964-1043

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jpeng56464@direct.beaumont.edu

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
I20161017001478 MI Practitioner - Obstetrics/Gynecology 0446483549 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oakland Macomb Obstetrics and Gynecology PCGroup PAC ID 4183673015, 23 clinicians
William Beaumont HospitalGroup PAC ID 9335051093, 20 clinicians

Practice addresses (Care Compare)

1701 S Blvd E
Suite 200
Rochester Hills, MI 48307-6116
Phone (248) 997-5805

26001 Jefferson Ave
Saint Clair Shores, MI 48081-2309
Phone (586) 779-7000

44201 Dequindre Rd
Troy, MI 48085-1117
Phone (248) 964-1043

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301101454MIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
William Beaumont Hospital Current Accepting new patients
Together Women's Health Medical Group, P.C. Obstetrics & Gynecology CurrentSince Jun 4, 2024 Accepting new patients
Oakland Macomb Obstetrics & Gynecology, PC Obstetrics & Gynecology CurrentSince Jan 1, 2021 Accepting new patients
Anesthesia Associates of Ann Arbor, PLLC PastSince Jan 1, 2021 Accepting new patients

Locations

1701 South Blvd E
Ste 200
Rochester Hills, MI 48307
Phone (248) 997-5805

1701 South Blvd E
Ste 350
Rochester Hills, MI 48307
Phone (248) 218-4075

26901 Beaumont Blvd
Ste 3D
Southfield, MI 48033
Phone (947) 522-1860

3290 W Big Beaver Rd
Ste 444
Troy, MI 48084
Phone (248) 816-9200

4550 Investment Dr
Ste 200
Troy, MI 48098
Phone (248) 267-5040

Interoperability endpoints

  • Direct secure messaging: jenniferpeng@omog.allscriptsdirect.net
  • Direct secure messaging: jpeng56464@direct.beaumont.edu

Organizations & group practices 4

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": "1340323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1245593359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849",
            "telephone_number": "947-522-1865",
            "fax_number": "947-522-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44250 DEQUINDRE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483141002",
            "telephone_number": "248-964-0400",
            "fax_number": "248-964-0401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3290 W. Big Beaver",
            "address_2": "Suite 444",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480842914",
            "country_code": "US",
            "telephone_number": "248-816-9200",
            "fax_number": "248-816-1017",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "44201 Dequindre Rd",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480851117",
            "country_code": "US",
            "telephone_number": "248-964-1043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENG",
        "first_name": "JENNIFER",
        "middle_name": "HUNG-WEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-22",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "4301101454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jpeng56464@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "44250 Dequindre Rd",
            "city": "Sterling Heights",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483141002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

Verify at the official NPI Registry.