NPIMap

Individual provider Active NPI

Michael L. Peck, D.O.

  • Family Medicine Physician
  • Plymouth Meeting, PA
National Provider Identifier
1265427306
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS006590L Issued in PA
Practice address
2901 Jolly Rd
Plymouth Meeting, PA 19462-2324
Phone
(717) 451-5956
NPI assigned
Sep 14, 2005
Last updated
Oct 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS006590L PA Primary
Addiction Medicine (Family Medicine) Physician 207QA0401X XP1503172 PA

Addresses

Primary practice location

2901 Jolly Rd
Plymouth Meeting, PA 19462-2324

Mailing address

3130 Grandview Rd
Hanover, PA 17331-9134
Phone (717) 632-2088

Other identifiers 1

IdentifierTypeStateIssuer
001133191MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20031115000042 PA Practitioner - General Practice 6608780531 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Philadelphia College of Osteopathic Medicine, 1987
Medicare assignment
May accept Medicare assignment
Group practices
Suburban Geriatric's, Inc.Group PAC ID 4486551371, 102 clinicians
Suburban Geriatrics II PCGroup PAC ID 9537552419, 107 clinicians
Violet Valley Long Term Care PCGroup PAC ID 9638683915, 55 clinicians

Practice addresses (Care Compare)

2901 Jolly Rd
Plymouth Meeting, PA 19462-2324
Phone (610) 272-8221

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.08 of 100Reported as group
Quality
76.48
Promoting interoperability
100
Improvement activities
40
Cost
77.12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS006590LPAMDFamily Medicine Physician
XP1503172PAMDAddiction Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Suburban Geriatrics II PC CurrentSince Sep 1, 2024 Accepting new patients
Pinnacle Health Medical Services CurrentSince Nov 1, 2018 Accepting new patients
Violet Valley Long Term Care PC CurrentSince Aug 18, 2025 Accepting new patients
Suburban Geriatrics, Inc. CurrentSince Sep 1, 2024 Accepting new patients
Pinnacle Health Medical Services Family Medicine CurrentSince Nov 1, 2018 Accepting new patients
Pinnacle Health Medical Services Family Medicine Current Accepting new patients
Wellspan Medical Group Past Accepting new patients
Homewood Living Plum Creek, Inc Past Accepting new patients
Colonial Opco LLC Past Accepting new patients
Lancashire Opco LLC Past Accepting new patients
Hanover Opco LLC Past Accepting new patients
Mt Hope Nazarene Retirement Community Past Accepting new patients
United Church of Christ Homes Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Pleasant Acres Operating, LLC Past Accepting new patients
The Meadows at Gettysburg for Nursing and Rehabilitation LLC Past Accepting new patients
Spiritrust Lutheran Past Accepting new patients

Locations

100 W Queen St
Dallastown, PA 17313
Phone (717) 244-6629

1404 Baltimore St
Ste 4
Hanover, PA 17331
Phone (717) 637-0470

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

2829 Lititz Pike
Lancaster, PA 17601
Phone (717) 397-4921

425 N Duke St
Lancaster, PA 17602
Phone (717) 397-4281

300 W King St
Littlestown, PA 17340
Phone (717) 359-9214

2901 Jolly Rd
Plymouth Mtng, PA 19462
Phone (610) 272-3222

2400 Kingston Ct
York, PA 17402
Phone (717) 755-8811

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mount Hope NazareneManheim, PA, CCN 396119 Skilled nursing facility Corporate Director
Operational/Managerial Control
Adp of the SNF		 Oct 2, 2022
Oct 2, 2022
Oct 2, 2022
Spiritrust Lutheran the Village at Sprenkle DriveYork, PA, CCN 395612 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Oct 12, 2025
Oct 8, 2025
Homewood at Plum CreekHanover, PA, CCN 395898 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2024
Apr 8, 2025
Neffsville Nursing and RehabilitationLancaster, PA, CCN 395205 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Oct 1, 2023
Jun 20, 2025

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 18

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 18

Hospital & facility affiliations 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1265427306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3130 GRANDVIEW RD",
            "city": "HANOVER",
            "state": "PA",
            "postal_code": "173319134",
            "telephone_number": "717-632-2088",
            "fax_number": "717-637-9482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 JOLLY RD",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194622324",
            "telephone_number": "717-451-5956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "MICHAEL",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS006590L",
            "primary": true
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "PA",
            "license": "XP1503172",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001133191",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth Meeting, PA

Sources for this page

Verify at the official NPI Registry.