NPIMap

Individual provider Active NPI

Mark Petrous, M.D.

  • Internal Medicine Physician
  • Livonia, MI
National Provider Identifier
1386781490
Registry record updated Jul 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301056981 Issued in MI
Practice address
20224 Farmington Rd
Livonia, MI 48152
Phone
(248) 442-0005
Fax
(248) 442-8843
NPI assigned
Jan 30, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 4301056981 MI Primary

Addresses

Primary practice location

20224 Farmington Rd
Livonia, MI 48152

Mailing address

20224 Farmington Rd
Livonia, MI 48152-1412
Phone (248) 442-0005

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
I20060508000087 MI Practitioner - Internal Medicine 8123039039 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

20224 Farmington Rd
Livonia, MI 48152-1412
Phone (248) 442-0005

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Contemporary Medical Solutions, PC Single Specialty CurrentSince Jan 5, 2006 Accepting new patients

Locations

20224 Farmington Rd
Livonia, MI 48152
Phone (248) 442-0005

Organizations & group practices 1

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 12

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": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531440000000",
    "number": "1386781490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20224 FARMINGTON RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481521412",
            "telephone_number": "248-442-0005",
            "fax_number": "248-442-8843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20224 FARMINGTON RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "48152",
            "telephone_number": "248-442-0005",
            "fax_number": "248-442-8843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROUS",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2018-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301056981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

Verify at the official NPI Registry.