Glenn George Betrus, M.D.
Individual provider Active NPI Urology Physician · Port Huron, MI
NPI 1376563130 · NPPES record last updated Jul 8, 2008
Key facts
- NPI
- 1376563130
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Urology Physician 208800000X
- License
- 4301052886 (MI)
- Practice address
- 1037 Water St
Suite 1
Port Huron, MI 48060-4408 - Phone
- (810) 984-4194
- Fax
- (810) 984-4674
- NPI assigned
- Jul 21, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 11
Medicare Care Compare profile
- Specialty
- Urology
- Education
- Wayne State University School of Medicine, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- McLaren Medical Group
Practice addresses (Care Compare)
1037 Water St
Suite 1
Port Huron, MI 48060-4408
Phone (810) 984-4194
1163 S Carney Dr
Saint Clair, MI 48079-5569
Phone (810) 561-8450
401 S Ballenger Hwy
Flint, MI 48532-3638
Phone (810) 342-2000
Hospital & facility affiliations
- McLaren Port Huron
- Lake Huron Medical Center
- McKenzie Health System
- Harbor Beach Community Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Prostate resection | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040505000077 | MI | Practitioner - Urology | 2567450141 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| McLaren Medical Group | Current |
Accepting new patients | |
| Michigan Healthcare Professionals PC | Current |
Accepting new patients | |
| Michigan Healthcare Professionals PC | Current | Accepting new patients | |
| Michigan Healthcare Professionals PC | Urology | Current |
Accepting new patients |
| McLaren Medical Group | Current |
Accepting new patients | |
| Urology Assoc of Port Huron, P.C. | Urology | Current | Accepting new patients |
| McLaren Medical Group | Past | Accepting new patients |
Locations
39373 Garfield Rd
Clinton Twp, MI 48038
Phone (586) 286-4880
29992 Northwestern Hwy
Ste C
Farmington Hills, MI 48334
Phone (248) 851-1430
27900 Grand River Ave
Ste 220
Farmington Hills, MI 48336
Phone (248) 477-0552
401 S Ballenger Hwy
Flint, MI 48532
Phone (810) 342-1000
1221 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-3300
1037 Water St
Ste 1
Port Huron, MI 48060
Phone (810) 984-4194
31157 Woodward Ave
Royal Oak, MI 48073
Phone (248) 288-2250
Interoperability endpoints
- gbetrus1117427@direct.hfhs.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 4301052886 | MI | Yes |
Addresses
Primary practice location
1037 Water St
Suite 1
Port Huron, MI 48060-4408
Mailing address
1037 Water St
Suite 1
Port Huron, MI 48060-4408
Phone (810) 984-4194
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 540G41006 | Other | MI | BLUE CROSS |
| 102916887 | Medicaid | MI |
Other providers in Port Huron, MI
- Jordan Elizabeth Bennett
- Melana Marie Bennett
- Deanna M Benoit
- Alfonso Bermea
- Best Kids PC
- Violet Christine Betrus
- Better Hearing Centers Inc.
- Better Vision Center
- Anshum Goel Bhalla
- Zubin Bhesania
All providers in Port Huron, MI · Urology Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2008. 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.
- Order and Referring (CMS).
- 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.