Michael Pauly Petrich, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

4301084289 Issued in MI

Practice address

18101 Oakwood Blvd
Dearborn, MI 48124-4089

Phone

(313) 436-2583

Fax

(313) 436-2809

NPI assigned

Aug 17, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Diagnostic Radiology

Education

Indiana University School of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Barbara Ann Karmanos Cancer InstituteGroup PAC ID 3870407901, 57 clinicians

McLaren Medical GroupGroup PAC ID 3971416082, 240 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Karmanos Cancer Center Hospital, Detroit, MI, CCN 230297
• McLaren Northern Michigan Hospital, Petoskey, MI, CCN 230105
• McLaren Bay Region Hospital, Bay City, MI, CCN 230041
• McLaren Central Michigan Hospital, Mount Pleasant, MI, CCN 230080

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mpetrich@direct.dmc.org

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.

• Barbara Ann Karmanos Cancer Institute

  • Mammography Clinic/Center
  • Detroit, MI
  • NPI 1225022288
  Medicare reassignment Care Compare group NPD
• McLaren Medical Group

  • Family Medicine Physician
  • Lapeer, MI
  • NPI 1346396066
  Medicare reassignment Care Compare group NPD
• Barbara Ann Karmanos Cancer Institute

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Detroit, MI
  • NPI 1386060226
  NPD
• McLaren Medical Group

  • Diagnostic Radiology Physician
  • Lapeer, MI
  • NPI 1073650750
  NPD

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

• Barbara Ann Karmanos Cancer Hospital

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1316900277
  Care Compare affiliation
• McLaren Bay Region

  • General Acute Care Hospital
  • Bay City, MI
  • NPI 1528031226
  Care Compare affiliation
• McLaren Central Michigan

  • Rural Acute Care Hospital
  • Mt Pleasant, MI
  • NPI 1619941317
  Care Compare affiliation
• McLaren Northern Michigan

  • Psychiatric Hospital Unit
  • Cheboygan, MI
  • NPI 1336897735
  Care Compare affiliation
• McLaren Northern Michigan

  • General Acute Care Hospital
  • Petoskey, MI
  • NPI 1992812580
  Care Compare affiliation

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

{
    "created_epoch": "1187308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187308800000",
    "number": "1669664173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18060 SNOW ROAD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "48124",
            "telephone_number": "313-436-2583",
            "fax_number": "313-436-2809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18101 OAKWOOD BLVD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481244089",
            "telephone_number": "313-436-2583",
            "fax_number": "313-436-2809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRICH",
        "first_name": "MICHAEL",
        "middle_name": "PAULY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-17",
        "last_updated": "2007-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301084289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vanessa J Peters, CRNA
• William John Peters, DPM
• Jordan James Petersen, DO
• Delani Alyse Peterson
• Ebony Peterson
• Shakyra Pettis
• Chelsea Marie Pettit, RN
• Lakia Tiara Pettway
• Lindsberg Shanard Pettway III
• Hayden Pfeifer-Mikula

• Diagnostic Radiology Physician in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Diagnostic Radiology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.

Verify at the official NPI Registry.