NPIMap

Individual provider Active NPI

Richard T Perry, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Saint Clair Shores, MI
National Provider Identifier
1467414052
Registry record updated Nov 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
RP066358 Issued in MI
Practice address
23829 Little Mack Ave
Suite 100
Saint Clair Shores, MI 48080-1186
Phone
(586) 773-1300
Fax
(586) 773-1600
NPI assigned
Apr 6, 2006
Last updated
Nov 27, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X RP066358 MI Primary

Addresses

Primary practice location

23829 Little Mack Ave
Suite 100
Saint Clair Shores, MI 48080-1186

Mailing address

23829 Little Mack Ave
Suite 100
Saint Clair Shores, MI 48080-1186
Phone (586) 773-1300

Other identifiers 3

IdentifierTypeStateIssuer
0821872OtherMIBLUE CROSS BLUE SHIELD
C4762OtherMIMCARE
3164704MedicaidMI

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
I20100607000025 MI Practitioner - Orthopedic Surgery 4082685631 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Michigan Medical School, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Semi Medical GroupGroup PAC ID 0648180406, shared by 4 NPIs, 246 clinicians

Practice addresses (Care Compare)

17900 23 Mile Rd
Macomb, MI 48044-1161
Phone (313) 647-3900

23829 Little Mack Ave
Suite 100
Saint Clair Shores, MI 48080-1186
Phone (586) 773-1300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement136
Knee replacement139
Removal of tissue20

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RP066358MIMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Clair Orthopaedics and Sports Medicine PC Orthopaedic Surgery CurrentSince Aug 1, 1995 Accepting new patients
St Clair Orthopaedics and Sports Medicine PC Orthopaedic Surgery CurrentSince Aug 1, 1995 Accepting new patients

Locations

22701 Hall Rd
Macomb, MI 48042
Phone (586) 260-4665

22701 Hall Rd
Ste 100
Macomb, MI 48042
Phone (586) 416-1300

45441 Heydenreich Rd
Macomb, MI 48044
Phone (586) 226-8600

23829 Little Mack Ave
Ste 100
St Clr Shores, MI 48080
Phone (586) 416-1300

Interoperability endpoints

  • Direct secure messaging: rperry@stclairortho.gwaydirect.com
  • Direct secure messaging: rperry63453@direct.hfhs.org

Organizations & group practices 2

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 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353974400000",
    "number": "1467414052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23829 LITTLE MACK AVE",
            "address_2": "SUITE 100",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801186",
            "telephone_number": "586-773-1300",
            "fax_number": "586-773-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23829 LITTLE MACK AVE",
            "address_2": "SUITE 100",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801186",
            "telephone_number": "586-773-1300",
            "fax_number": "586-773-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "RICHARD",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2012-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "MI",
            "license": "RP066358",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0821872",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCARE",
            "identifier": "C4762",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3164704",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.