Active NPI
Kenneth M Peters, MD
- Urology Physician
- Royal Oak, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 4301057436
- Practice address
- 3601 W 13 Mile Rd
Royal Oak, MI 48073-6712 - Phone
- (248) 898-0898
- NPI assigned
- Nov 3, 2005
- Last updated
- Jul 21, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 4301057436 | MI | Primary |
Addresses
Primary practice location
3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Mailing address
26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849
Other practice location 1
1915 E 14 Mile Rd
Birmingham, MI 48009-7244
Phone (248) 642-4474
Other practice location 2
3535 W 13 Mile Rd Ste 404
Royal Oak, MI 48073-6770
Phone (248) 551-3535
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3384459 | Medicaid | MI |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kpeters8062@direct.beaumont.edu |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Urology
- Education
- Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
28100 Grand River Ave
Farmington Hills, MI 48336-5970
3535 W 13 Mile Rd
Royal Oak, MI 48073-6770
3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
3601 W 13 Mile Rd Ec
Beaumont Emergency Services Ro
Royal Oak, MI 48073-6712
Phone (248) 898-5058
Hospital & facility affiliations
- Beaumont Hospital Royal Oak
- Beaumont Hospital, Troy
- University of Michigan Health System
- Beaumont Hospital - Dearborn
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.37 of 100
- Quality
- 66.73
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 70.98
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Prostate resection | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301057436 | MI | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michigan Healthcare Professionals PC | Current | Accepting new patients | |
| Beaumont Medical Group- Specialty Services | Current | Accepting new patients | |
| Michigan Healthcare Professionals PC | Current | Accepting new patients | |
| Birmingham Urological Associates, P.C. | Urology | Past | Accepting new patients |
Locations
27900 Grand River Ave
Ste 220
Farmington Hills, MI 48336
Phone (248) 477-0552
28100 Grand River Ave
Ste 301
Farmington Hills, MI 48336
Phone (947) 521-1320
29992 Northwestern Hwy
Ste C
Farmington Hills, MI 48334
Phone (248) 851-1430
1221 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-3300
31157 Woodward Ave
Royal Oak, MI 48073
Phone (248) 288-2250
3535 W 13 Mile Rd
Royal Oak, MI 48073
Phone (248) 551-1010
3535 W 13 Mile Rd
Ste 404
Royal Oak, MI 48073
Phone (248) 551-0640
3601 W 13 Mile Rd
Royal Oak, MI 48073
26901 Beaumont Blvd
Ste 3D
Southfield, MI 48033
Phone (947) 522-1860
Interoperability endpoints
- kpeters83016@epic00.corewelldirect.org
Organizations & group practices 4
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.
-
- Surgery Physician
- Royal Oak, MI
- NPI 1578072906
-
- Internal Medicine Physician
- Farmington Hills, MI
- NPI 1295023547
-
dba Urology Specialist of Michigan
- Durable Medical Equipment & Medical Supplies
- Lapeer, MI
- NPI 1992693303
-
- Urology Physician
- Birmingham, MI
- NPI 1801971197
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Beaumont Outpatient Diabetes Education
- Community Health Clinic/Center
- Dearborn, MI
- NPI 1790414670
Hospital
-
dba Beaumont Hospital - Dearborn
- General Acute Care Hospital
- Dearborn, MI
- NPI 1740230119
-
dba University of Michigan Health System
- General Acute Care Hospital
- Ann Arbor, MI
- NPI 1003878539
-
dba Beaumont Hospital, Troy
- General Acute Care Hospital
- Troy, MI
- NPI 1306825997
-
dba Beaumont Hospital, Royal Oak
- General Acute Care Hospital
- Royal Oak, MI
- NPI 1689653305
-
dba Beaumont Hospital, Grosse Pointe
- General Acute Care Hospital
- Grosse Pointe, MI
- NPI 1932396017
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689897600000",
"number": "1417948944",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26901 BEAUMONT BLVD STE 3D",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480333849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3601 W 13 MILE RD",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "480736712",
"telephone_number": "248-898-0898"
}
],
"practiceLocations": [
{
"address_1": "1915 E 14 Mile Rd",
"address_purpose": "LOCATION",
"city": "Birmingham",
"state": "MI",
"postal_code": "480097244",
"country_code": "US",
"telephone_number": "248-642-4474",
"fax_number": "248-642-4499",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3535 W 13 Mile Rd Ste 404",
"address_purpose": "LOCATION",
"city": "Royal Oak",
"state": "MI",
"postal_code": "480736770",
"country_code": "US",
"telephone_number": "248-551-3535",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PETERS",
"first_name": "KENNETH",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-03",
"last_updated": "2023-07-21",
"certification_date": "2023-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "MI",
"license": "4301057436",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3384459",
"state": "MI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kpeters8062@direct.beaumont.edu",
"affiliation": "N",
"address_1": "3601 W 13 Mile Rd",
"city": "Royal Oak",
"state": "MI",
"country_code": "US",
"postal_code": "480736712",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Royal Oak, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.