Individual provider Active NPI

Justin Gregory Peacock, M.D., PH.D.

  • Diagnostic Radiology Physician
  • Bethesda, MD
National Provider Identifier
1336563493
Registry record updated May 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
28970 Issued in NE
Practice address
8901 Rockville Pike
Bethesda, MD 20889-0001
Phone
(301) 295-9151
NPI assigned
Feb 10, 2014
Last updated
May 6, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Medicine Physician 207U00000X MD485441 PA
Nuclear Medicine Physician 207U00000X 4301512179 MI
Diagnostic Radiology Physician 2085R0202X MD485441 PA
Nuclear Medicine Physician 207U00000X 28970 NE
Diagnostic Radiology Physician 2085R0202X 28970 NE Primary

Addresses

Primary practice location

8901 Rockville Pike
Bethesda, MD 20889-0001

Mailing address

8901 Rockville Pike
Bethesda, MD 20889-0001
Phone (301) 295-9151

Other practice location 1

4660 S Hagadorn Rd Ste 510
East Lansing, MI 48823-6805
Phone (517) 353-5053

Other practice location 2

20 Expedition Trl Ste 103
Gettysburg, PA 17325-8599
Phone (717) 337-5991

Other practice location 3

3220 Discovery Dr Ste 100
Lansing, MI 48910-8609
Phone (517) 975-8930

Other practice location 4

4660 S Hagadorn Rd Ste 410
East Lansing, MI 48823-6819
Phone (517) 353-5053

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, DC, MI, PA4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20230911003313 TX Practitioner - Diagnostic RadiologyPractitioner - Nuclear Medicine 0547624439 Practice locations: El Paso, TX
I20240322000028 DC Practitioner - Diagnostic Radiology 0547624439 Reassigns benefits to 1 organization
I20240718003620 MI Practitioner - Nuclear Medicine 0547624439 Reassigns benefits to 1 organization
I20240809003873 PA Practitioner - Nuclear MedicinePractitioner - Diagnostic Radiology 0547624439 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301512179MIMDNuclear Medicine Physician
28970NEMDNuclear Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Round Rock Imaging LLC CurrentSince Jan 1, 2025 Accepting new patients
Preferred Imaging of Mesquite LLC Diagnostic Radiology CurrentSince Jan 1, 2025 Accepting new patients
Preferred Imaging of McKinney, LLC Diagnostic Radiology CurrentSince Jan 1, 2025 Accepting new patients
Preferred Open MRI, LLC Diagnostic Radiology CurrentSince Jan 1, 2025 Accepting new patients
Preferred Imaging of Garland, LLC Diagnostic Radiology CurrentSince Jan 1, 2026 Accepting new patients
Preferred Imaging of Amarillo, LLC CurrentSince Jan 1, 2025 Accepting new patients
Akumin Imaging Texas LLC CurrentSince May 22, 2023 Accepting new patients
Msu Health Care Inc. Diagnostic Radiology CurrentSince Jun 24, 2024 Accepting new patients
Preferred Imaging of Austin LLC Diagnostic Radiology CurrentSince Jan 1, 2025 Accepting new patients
Maryland Imaging Network PC Diagnostic Radiology CurrentSince Feb 26, 2024 Accepting new patients
Preferred Imaging of Grapevine/Colleyville, LLC CurrentSince Jan 1, 2025 Accepting new patients
Preferred Imaging of Irving LLC Diagnostic Radiology CurrentSince Jan 1, 2025 Accepting new patients
Meadville Medical Center Nuclear Medicine CurrentSince Jun 28, 2024 Accepting new patients
Meadville Medical Center CurrentSince Jun 28, 2024 Accepting new patients
Msu Health Care Inc. CurrentSince Jun 24, 2024 Accepting new patients
Msu Health Care Inc Current Accepting new patients
Preferred Imaging of Corinth, LLC CurrentSince Jan 1, 2025 Accepting new patients
Preferred Imaging of Plano, LLC CurrentSince Jan 1, 2025 Accepting new patients
Preferred Imaging of Frisco, LLC Diagnostic Radiology CurrentSince Jan 1, 2025 Accepting new patients
Chesapeake Urology Associates LLC CurrentSince May 30, 2024 Accepting new patients
Advanced Radiology Services PC Diagnostic Radiology Past Accepting new patients

Locations

4660 S Hagadorn Rd
Ste 410
East Lansing, MI 48823
Phone (517) 884-6132

4660 S Hagadorn Rd
Ste 500
East Lansing, MI 48823
Phone (517) 432-6144

4660 S Hagadorn Rd
Ste 510
East Lansing, MI 48823
Phone (517) 884-7450

804 Service Rd
Ste A202
East Lansing, MI 48824
Phone (517) 884-2976

3220 Discovery Dr
Ste 100
Lansing, MI 48910
Phone (517) 975-8930

1 Medical Center Blvd
Ste 341
Chester, PA 19013
Phone (610) 619-7420

20 Expedition Trl
Ste 100
Gettysburg, PA 17325
Phone (717) 334-8333

20 Expedition Trl
Ste 101
Gettysburg, PA 17325
Phone (717) 334-4033

20 Expedition Trl
Ste 103
Gettysburg, PA 17325
Phone (717) 337-5991

1034 Grove St
Meadville, PA 16335
Phone (814) 333-5728

751 Liberty St
Meadville, PA 16335
Phone (814) 333-5081

10501 Gateway Blvd W
Ste 140
El Paso, TX 79925
Phone (915) 544-7300

Organizations & group practices 21

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 21

NPI Registry JSON

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

{
    "created_epoch": "1391990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778025600000",
    "number": "1336563493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8901 ROCKVILLE PIKE",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208890001",
            "telephone_number": "301-295-9151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 ROCKVILLE PIKE",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208890001",
            "telephone_number": "301-295-9151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4660 S Hagadorn Rd Ste 510",
            "address_purpose": "LOCATION",
            "city": "East Lansing",
            "state": "MI",
            "postal_code": "488236805",
            "country_code": "US",
            "telephone_number": "517-353-5053",
            "fax_number": "517-884-7640",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20 Expedition Trl Ste 103",
            "address_purpose": "LOCATION",
            "city": "Gettysburg",
            "state": "PA",
            "postal_code": "173258599",
            "country_code": "US",
            "telephone_number": "717-337-5991",
            "fax_number": "717-337-5995",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3220 Discovery Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "489108609",
            "country_code": "US",
            "telephone_number": "517-975-8930",
            "fax_number": "517-337-4985",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4660 S Hagadorn Rd Ste 410",
            "address_purpose": "LOCATION",
            "city": "East Lansing",
            "state": "MI",
            "postal_code": "488236819",
            "country_code": "US",
            "telephone_number": "517-353-5053",
            "fax_number": "517-884-7640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEACOCK",
        "first_name": "JUSTIN",
        "middle_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-10",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "PA",
            "license": "MD485441",
            "primary": false
        },
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "MI",
            "license": "4301512179",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD485441",
            "primary": false
        },
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "NE",
            "license": "28970",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NE",
            "license": "28970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

Verify at the official NPI Registry.