Individual provider Active NPI

Joel A. Perlson, D.O.

  • Family Medicine Physician
  • Southgate, MI
National Provider Identifier
1649243676
Registry record updated Oct 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101006866 Issued in MI
Practice address
15777 Northline Rd Ste 200
Southgate, MI 48195-2354
Phone
(734) 246-8100
Fax
(313) 581-0228
NPI assigned
Feb 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 5101006866 MI
Family Medicine Physician 207Q00000X 5101006866 MI Primary

Addresses

Primary practice location

15777 Northline Rd Ste 200
Southgate, MI 48195-2354

Mailing address

26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849

Other identifiers 3

IdentifierTypeStateIssuer
3078099MedicaidMI
0Q260790OtherMIBCBSM
010049845OtherMIPALMETTO

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
I20080701000588 MI Practitioner - Family Practice 0941372239 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
92.74 of 100Reported as group
Quality
87.98
Promoting interoperability
100
Improvement activities
40
Cost
80.63

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101006866MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ark Multispecialty Physicians PLLC CurrentSince Sep 1, 2017 Accepting new patients

Locations

25130 Southfield Rd
Ste 120
Southfield, MI 48075
Phone (248) 234-6790

25130 Southfield Rd
Ste 230
Southfield, MI 48075
Phone (248) 234-6790

25130 Southfield Rd
Ste 105
Southfield, MI 48075
Phone (248) 234-6790

Organizations & group practices 1

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": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1649243676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15777 NORTHLINE RD STE 200",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952354",
            "telephone_number": "734-246-8100",
            "fax_number": "313-581-0228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERLSON",
        "first_name": "JOEL",
        "middle_name": "A.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "5101006866",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101006866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3078099",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0Q260790",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO",
            "identifier": "010049845",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southgate, MI

Sources for this page

Verify at the official NPI Registry.