Lapeer Pediatrics, P.C.
Organization Active NPI Primary Care Clinic/Center · Lapeer, MI
NPI 1265623276 · NPPES record last updated Sep 11, 2025
Key facts
- NPI
- 1265623276
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Clinic/Center 261QP2300X
- License
- 4301067273 (MI)
- Legal business name
- LAPEER PEDIATRICS, P.C.
- Practice address
- 1083 Suncrest Dr
Suite-a
Lapeer, MI 48446-4421 - Phone
- (810) 245-9700
- Fax
- (810) 245-9703
- NPI assigned
- Aug 5, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Mohammad Al Harastani, M.D.
- Title
- President
- Phone
- (810) 245-9700
Practitioners 5
-
Katelyn Bailey, NP
-
Jennifer Sophia Heckmann, PA-C
-
Sophia Seneker, PA-C
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 23D1078237 | Lapeer Pediatrics | Certificate of waiver | Jan 3, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080102000586 | MI | Part B Supplier - Clinic/Group Practice | 8729168877 |
Receives reassigned benefits from 3 practitioners Practice locations: Lapeer, MI |
National Provider Directory
Locations
6140 Rashelle Dr
Unit 1
Flint, MI 48507
1075 Suncrest Dr
Ste B
Lapeer, MI 48446
Phone (810) 245-9700
1083 Suncrest Dr
Ste A
Lapeer, MI 48446
Phone (810) 245-9700
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | 4301067273 | MI | Yes |
Addresses
Primary practice location
1083 Suncrest Dr
Suite-a
Lapeer, MI 48446-4421
Mailing address
1083 Suncrest Dr Ste a
Lapeer, MI 48446-4421
Phone (810) 245-9700
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 350D410030 | Other | MI | BLUE CARE NETWORK |
| 526 | Other | MI | PPOM |
| 1026494 | Other | MI | MCLAREN HEALTH PLAN |
| 41A87114 | Other | MI | HEALTH PLUS |
| 8572330001 | Other | MI | CIGNA |
| F76263 | Other | MI | HEALTH ALLIANCE PLAN |
| 0P48210 | Other | MEDICARE PTAN NUMBER | |
| 35-0-44-1237-1 | Other | MI | BCBS |
| 1026494 | Other | MI | MCLAREN HEALTH ADVANTAGE |
| 1619968922 | Medicaid | MI | |
| 5243111 | Other | MI | AETNA |
Other providers in Lapeer, MI
- Lapeer Medical Associates PC
- Lapeer Medical Associates, PC
- Lapeer Medical Diagnostics PC
- Lapeer Mi Opco LLC
- Lapeer Neurology Associates PC
- Lapeer Physical Therapy LLC
- Lapeer Sleep Diagnostic Center Inc.
- Lapeer Spirit & Guidance Counseling Center
- Lapeer Team Work, Inc
- Lapeer Wellness PLLC
All providers in Lapeer, MI · Primary Care Clinic/Center in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.