Individual provider Active NPI

Gerald T Pruitt, DO

  • Pulmonary Disease Physician
  • Owosso, MI
National Provider Identifier
1356399232
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
5101015307 Issued in MI
Practice address
802 W King St Ste J
Owosso, MI 48867-2100
Phone
(989) 729-4071
Fax
(989) 729-4072
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 5101015307 MI Primary

Addresses

Primary practice location

802 W King St Ste J
Owosso, MI 48867-2100

Mailing address

802 W King St Ste J
Owosso, MI 48867-2100
Phone (989) 729-4071

Other practice location 1

826 W King St Ste 200
Owosso, MI 48867-2120
Phone (989) 729-4071

Other identifiers 1

IdentifierTypeStateIssuer
1356399232MedicaidMI

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
I20070713000820 MI Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 3577597640 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Internal Medicine
Education
Michigan State University College of Osteopathic Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial HospitalGroup PAC ID 8527976497, 210 clinicians

Practice addresses (Care Compare)

826 W King St
Memorial Medical Associates
Owosso, MI 48867-2120
Phone (989) 723-5211

Hospital & facility affiliations

  • Memorial Healthcare Hospital, Owosso, MI, CCN 230121

Merit-based Incentive Payment System (MIPS)

Final score
82.58 of 100Reported as group
Quality
58.15
Promoting interoperability
100
Improvement activities
40
Cost
74.45

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital CurrentSince Oct 1, 2019 Accepting new patients
Memorial Hospital CurrentSince Oct 1, 2019 Accepting new patients
Hospitalist Medicine Physicians of Michigan, PLLC Internal Medicine CurrentSince Jun 29, 2019 Accepting new patients
Hospitalist Medicine Physicians of Michigan PLLC Internal Medicine CurrentSince Jun 29, 2019 Accepting new patients
Memorial Hospital Internal Medicine Current Accepting new patients
Sound Inpatient Physicians-Michigan, PLLC Internal Medicine CurrentSince Feb 25, 2016 Accepting new patients
Memorial Hospital Past Accepting new patients
Pennant Physician Services Past Accepting new patients
Primedoc of Norfolk PC Internal Medicine Past Accepting new patients
Mercy Hospital Grayling Past Accepting new patients
Metropolitan Hospital Past Accepting new patients

Locations

818 Riverside Ave
Adrian, MI 49221
Phone (517) 263-0711

400 Hobart St
Cadillac, MI 49601
Phone (231) 876-7200

9000 Peet Rd
Chesaning, MI 48616
Phone (989) 720-2273

1721 S Stephenson Ave
Iron Mountain, MI 49801
Phone (906) 776-5415

1 Atkinson Dr
Ludington, MI 49431
Phone (231) 843-2591

1465 E Parkdale Ave
Manistee, MI 49660
Phone (231) 398-1000

580 W College Ave
Marquette, MI 49855
Phone (906) 225-3131

200 Health Park Dr
Ste 202
Owosso, MI 48867
Phone (989) 723-8666

826 W King St
Owosso, MI 48867
Phone (989) 720-2273

802 W King St
Ste J
Owosso, MI 48867
Phone (989) 725-9247

826 W King St
Ste 200
Owosso, MI 48867
Phone (989) 729-4071

3337 Britton Rd
Perry, MI 48872
Phone (517) 625-3004

Interoperability endpoints

  • Direct secure messaging: g.pruitt@memorialhealthcare.midirect.net

Organizations & group practices 11

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 1

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1356399232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 W KING ST STE J",
            "city": "OWOSSO",
            "state": "MI",
            "postal_code": "488672100",
            "telephone_number": "989-729-4071",
            "fax_number": "989-729-4072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 W KING ST STE J",
            "city": "OWOSSO",
            "state": "MI",
            "postal_code": "488672100",
            "telephone_number": "989-729-4071",
            "fax_number": "989-729-4072"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "826 W King St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Owosso",
            "state": "MI",
            "postal_code": "488672120",
            "country_code": "US",
            "telephone_number": "989-729-4071",
            "fax_number": "989-729-4072",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRUITT",
        "first_name": "GERALD",
        "middle_name": "T",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MI",
            "license": "5101015307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356399232",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Owosso, MI

Sources for this page

Verify at the official NPI Registry.