Individual provider Active NPI

Peter Lundeen, MD

  • Family Medicine Physician
  • Grand Rapids, MI
National Provider Identifier
1467513234
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301036573 Issued in MI
Practice address
275 Michigan St NE
Grand Rapids, MI 49503-2531
Phone
(616) 267-0800
Fax
(616) 267-0801
NPI assigned
Dec 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301036573 MI Primary

Addresses

Primary practice location

275 Michigan St NE
Grand Rapids, MI 49503-2531

Mailing address

100 Michigan St NE
Grand Rapids, MI 49503-2560
Phone (616) 486-4059

Other identifiers 1

IdentifierTypeStateIssuer
4784301MedicaidMI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address plundeenmd8393@epic00.shdirect.org
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071109000554 MI Practitioner - Family Practice 1850369927 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Michigan Medical School, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spectrum Health HospitalsGroup PAC ID 8921904764, 161 clinicians

Practice addresses (Care Compare)

100 Michigan Ave NE
Grand Rapids, MI 49503-2560
Phone (616) 391-1774

100 Michigan St Northeast
Corewell Health Grand Rapids Hospit
Grand Rapids, MI 49503-2560
Phone (616) 391-1774

275 Michigan St NE
Grand Rapids, MI 49503-2531
Phone (616) 391-3777

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301036573MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health United CurrentSince Nov 6, 2020 Accepting new patients
Spectrum Health Hospitals CurrentSince Jul 8, 2019 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jul 27, 2011 Accepting new patients
Spectrum Health United Family Medicine CurrentSince Nov 6, 2020 Accepting new patients
Spectrum Health Hospitals CurrentSince Jul 8, 2019 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jul 27, 2011 Accepting new patients
Spectrum Health Primary Care Partners Current Accepting new patients

Locations

1227 W State St
Belding, MI 48809
Phone (616) 794-0800

2249 Wealthy St SE
Ste 110
Grand Rapids, MI 49506
Phone (616) 391-4600

25 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 267-0800

4085 Burton St SE
Ste 200
Grand Rapids, MI 49546

275 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 267-7900

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

25 Michigan St NE
Ste 5100
Grand Rapids, MI 49503
Phone (616) 267-0800

1300 Michigan St NE
Ste 103
Grand Rapids, MI 49503
Phone (616) 459-8338

100 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1680

330 Barclay Ave NE
Ste 104
Grand Rapids, MI 49503
Phone (616) 267-9823

1202 W Oak St
Greenville, MI 48838
Phone (616) 754-2944

602 Michigan Ave
Holland, MI 49423
Phone (616) 394-3350

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

Interoperability endpoints

  • Direct secure messaging: plundeen8393@epic00.corewelldirect.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1467513234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-486-4059",
            "fax_number": "616-486-4152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 MICHIGAN ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032531",
            "telephone_number": "616-267-0800",
            "fax_number": "616-267-0801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDEEN",
        "first_name": "PETER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301036573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4784301",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "plundeenmd8393@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "100 Michigan St NE",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495032560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "100 Michigan St NE",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495032560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.