Active NPI
Thomas J Petinga, D.O.
- Emergency Medicine Physician
- West Bloomfield, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 5101006927
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| TP006927 | Other | CHAMPUS-CHAMPUS | |
| TP006927 | Other | COMMERCIAL-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
Enrollment records 1
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5101006927 | MI | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SJMH Medical Practice-SMHC | Current | Accepting new patients | |
| Iha Health Services Corporation | Current | Accepting new patients | |
| SJMH Medical Practice-SMHC | Current | Accepting new patients | |
| Iha Health Services Corporation | Current | Accepting new patients | |
| Iha Health Service Corporation | Current | Accepting new patients | |
| Independent Emergency Physicians, P.C. | Past | 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
- 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.
-
dba IHA Canton Obstetrics and Gynecology
- Obstetrics & Gynecology Physician
- Canton, MI
- NPI 1457408965
-
- Internal Medicine Physician
- Pontiac, MI
- NPI 1346284684
-
dba Trinity Health IHA Medical Group OB/GYN Float
- Obstetrics & Gynecology Physician
- Ypsilanti, MI
- NPI 1831053701
-
dba IHA Urgent Care-Domino's Farms
- Urgent Care Clinic/Center
- Ann Arbor, MI
- NPI 1992937023
-
- Urgent Care Clinic/Center
- Waterford, MI
- NPI 1366644551
-
- Emergency Medical Services (Emergency Medicine) Physician
- Southfield, MI
- NPI 1780791343
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba St Joseph Mercy Oakland
- General Acute Care Hospital
- Pontiac, MI
- NPI 1053356352
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.