NPIMap

Individual provider Active NPI

Peter V Vaitkevicius, MD

  • Cardiovascular Disease Physician
  • Dearborn, MI
National Provider Identifier
1477590461
Registry record updated Jul 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
4301049384 Issued in MI
Practice address
18181 Oakwood Blvd
Suite 101
Dearborn, MI 48124-0000
Phone
(313) 996-7280
NPI assigned
May 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 4301049384 MI Primary
Internal Medicine Physician 207R00000X 4301049384 MI
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 4301049384 MI

Addresses

Primary practice location

18181 Oakwood Blvd
Suite 101
Dearborn, MI 48124-0000

Mailing address

18181 Oakwood Blved
Suite 101
Dearborn, MI 48124
Phone (313) 996-7280

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
I20050411000726 MI Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Geriatric Medicine 1850338955 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Wayne State University School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baraga County Memorial HospitalGroup PAC ID 7416866611, shared by 6 NPIs, 17 clinicians

Practice addresses (Care Compare)

18341 US Hwy 41
Lanse, MI 49946-8024
Phone (906) 524-3320

Hospital & facility affiliations

  • Baraga County Memorial Hospital Hospital, L' Anse, MI, CCN 231307
  • Aspirus Keweenaw Hospital and Clinics Hospital, Laurium, MI, CCN 231319
  • Aspirus Wausau Hospital Hospital, Wausau, WI, CCN 520030

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301049384MIMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baraga County Memorial Hospital CurrentSince Jan 4, 2024 Accepting new patients
Baraga County Memorial Hospital Current Accepting new patients
Baraga County Memorial Hospital Cardiovascular Disease CurrentSince Jan 4, 2024 Accepting new patients
Baraga County Memorial Hospital Current Accepting new patients
University Physician Group Internal Medicine Past Accepting new patients

Locations

18341 US Highway 41
Lanse, MI 49946
Phone (906) 524-3300

Organizations & group practices 5

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 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": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373500800000",
    "number": "1477590461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18181 OAKWOOD BLVED",
            "address_2": "SUITE 101",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "48124",
            "telephone_number": "313-996-7280",
            "fax_number": "313-996-7295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18181 OAKWOOD BLVD",
            "address_2": "SUITE 101",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481240000",
            "telephone_number": "313-996-7280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAITKEVICIUS",
        "first_name": "PETER",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2013-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301049384",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301049384",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MI",
            "license": "4301049384",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.