NPIMap

Individual provider Active NPI

Glenn George Betrus, M.D.

  • Urology Physician
  • Port Huron, MI
National Provider Identifier
1376563130
Registry record updated Jul 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
4301052886 Issued in 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
Last updated
Jul 8, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 4301052886 MI Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20040505000077 MI Practitioner - Urology 2567450141 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
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 GroupGroup PAC ID 3971416082, 240 clinicians

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Medical Group CurrentSince Jun 25, 2018 Accepting new patients
Michigan Healthcare Professionals PC Current Accepting new patients
McLaren Medical Group CurrentSince Jun 25, 2018 Accepting new patients
Urology Assoc of Port Huron, P.C. Urology Current Accepting new patients
Michigan Healthcare Professionals PC Urology CurrentSince Nov 1, 2011 Accepting new patients
Michigan Healthcare Professionals PC CurrentSince Nov 1, 2011 Accepting new patients
McLaren Medical Group Past Accepting new patients

Locations

39373 Garfield Rd
Clinton Twp, MI 48038
Phone (586) 286-4880

27900 Grand River Ave
Ste 220
Farmington Hills, MI 48336
Phone (248) 477-0552

29992 Northwestern Hwy
Ste C
Farmington Hills, MI 48334
Phone (248) 851-1430

401 S Ballenger Hwy
Flint, MI 48532
Phone (810) 342-1000

1037 Water St
Ste 1
Port Huron, MI 48060
Phone (810) 984-4194

1221 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-3300

31157 Woodward Ave
Royal Oak, MI 48073
Phone (248) 288-2250

Interoperability endpoints

  • Direct secure messaging: gbetrus1117427@direct.hfhs.org

Organizations & group practices 7

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.

Hospital & facility affiliations 11

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215475200000",
    "number": "1376563130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1037 WATER ST",
            "address_2": "SUITE 1",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480604408",
            "telephone_number": "810-984-4194",
            "fax_number": "810-984-4674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1037 WATER ST",
            "address_2": "SUITE 1",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480604408",
            "telephone_number": "810-984-4194",
            "fax_number": "810-984-4674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETRUS",
        "first_name": "GLENN",
        "middle_name": "GEORGE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2008-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MI",
            "license": "4301052886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

Verify at the official NPI Registry.