Individual provider Active NPI

Thomas J Petinga, D.O.

  • Emergency Medicine Physician
  • West Bloomfield, MI
National Provider Identifier
1548217706
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
5101006927 Issued in MI
Practice address
Henry Ford Health System
6777 West Maple Road
West Bloomfield, MI 48322
Phone
(248) 661-6490
Fax
(248) 661-6447
NPI assigned
May 30, 2006
Sex
Male
Sole proprietor
No

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
Emergency Medicine Physician 207P00000X 5101006927 MI Primary

Addresses

Primary practice location

Henry Ford Health System
6777 West Maple Road
West Bloomfield, MI 48322

Mailing address

Henry Ford Health System
6777 West Maple Road
West Bloomfield, MI 48322
Phone (248) 661-6490

Other identifiers 2

IdentifierTypeStateIssuer
TP006927OtherCHAMPUS-CHAMPUS
TP006927OtherCOMMERCIAL-COMMERCIAL NUMBER

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
I20070329000583 MI Practitioner - Emergency Medicine 7618945452 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

4400 Highland Rd
Waterford, MI 48328-1222
Phone (248) 618-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101006927MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SJMH Medical Practice-SMHC CurrentSince Oct 27, 2014 Accepting new patients
Iha Health Services Corporation CurrentSince May 1, 2020 Accepting new patients
SJMH Medical Practice-SMHC CurrentSince Oct 27, 2014 Accepting new patients
Iha Health Services Corporation Current Accepting new patients
Iha Health Service Corporation CurrentSince May 1, 2020 Accepting new patients
Independent Emergency Physicians, P.C. PastSince Oct 12, 2025 Accepting new patients

Locations

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

2305 Genoa Business Park Dr
Ste 200
Brighton, MI 48114
Phone (810) 494-6840

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

1255 E M 36
Pinckney, MI 48169
Phone (734) 878-1000

44405 Woodward Ave
Pontiac, MI 48341
Phone (248) 858-3000

44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700

5210 Highland Rd
Ste 101
Waterford, MI 48327
Phone (248) 673-2474

4400 Highland Rd
Waterford, MI 48328
Phone (248) 618-6000

Interoperability endpoints

  • Direct secure messaging: tpetinga23908@direct.trinity-health.org

Organizations & group practices 6

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548217706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HENRY FORD HEALTH SYSTEM",
            "address_2": "6777 WEST MAPLE ROAD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "48322",
            "telephone_number": "248-661-6490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HENRY FORD HEALTH SYSTEM",
            "address_2": "6777 WEST MAPLE ROAD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "48322",
            "telephone_number": "248-661-6490",
            "fax_number": "248-661-6447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETINGA",
        "first_name": "THOMAS",
        "middle_name": "J",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101006927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS-CHAMPUS",
            "identifier": "TP006927",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL-COMMERCIAL NUMBER",
            "identifier": "TP006927",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

Verify at the official NPI Registry.