Individual provider Active NPI

Vincenzo Guglielmetti, M.D.

  • Family Medicine Physician
  • Lake Orion, MI
National Provider Identifier
1508958737
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301072945 Issued in MI
Practice address
1375 S. Lapeer Rd.
Ste. 106
Lake Orion, MI 48360
Phone
(248) 693-9040
Fax
(248) 696-9007
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 4301072945 MI Primary

Addresses

Primary practice location

1375 S. Lapeer Rd.
Ste. 106
Lake Orion, MI 48360

Mailing address

29877 Telegraph Rd
Suite 304
Southfield, MI 48034-1332
Phone (248) 377-4188

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20201001001212 IN Practitioner - Family Practice 5092894550 Reassigns benefits to 1 organization
I20201103002656 IL Practitioner - Family Practice 5092894550 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Immediate Care North Chicago LLC CurrentSince Jul 1, 2023 Accepting new patients
Pic Indiana PC CurrentSince Nov 1, 2022 Accepting new patients
Integrated Physician Solutions PC PastSince Sep 3, 2017 Accepting new patients

Locations

1663 Belvidere Rd
Belvidere, IL 61008
Phone (815) 544-0040

4211 N Cicero Ave
Chicago, IL 60641
Phone (773) 794-1000

13448 Cicero Ave
Crestwood, IL 60418
Phone (708) 682-3384

4800 W 129th St
Merrionette Park, IL 60803
Phone (708) 377-2169

2524 N Illinois St
Swansea, IL 62226
Phone (618) 235-0605

123 S Franklin Rd
Bloomington, IN 47404
Phone (812) 339-2305

924 W Pike St
Goshen, IN 46526
Phone (574) 312-7056

4903 S Emerson Ave
Indianapolis, IN 46203
Phone (317) 352-5582

102 Sagamore Pkwy S
Lafayette, IN 47905
Phone (765) 237-3224

505 W Cleveland Rd
Mishawaka, IN 46545
Phone (574) 235-3135

1313 W McGalliard Rd
Muncie, IN 47303
Phone (765) 216-3115

1634 Gull Rd
Kalamazoo, MI 49048
Phone (269) 903-2835

3550 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-2530

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508958737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29877 TELEGRAPH RD",
            "address_2": "SUITE 304",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341332",
            "telephone_number": "248-377-4188",
            "fax_number": "248-223-9302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1375 S. LAPEER RD.",
            "address_2": "STE. 106",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "48360",
            "telephone_number": "248-693-9040",
            "fax_number": "248-696-9007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUGLIELMETTI",
        "first_name": "VINCENZO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301072945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Orion, MI

Sources for this page

Verify at the official NPI Registry.