NPIMap

Individual provider Active NPI

Brandon C Peltier, D.O.

  • Family Medicine Physician
  • Cadillac, MI
National Provider Identifier
1679566863
Registry record updated Dec 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
BP014907 Issued in MI
Practice address
827 E Division St
Cadillac, MI 49601-2015
Phone
(231) 775-9741
Fax
(231) 775-9333
NPI assigned
Aug 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2016

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 BP014907 MI Primary

Addresses

Primary practice location

827 E Division St
Cadillac, MI 49601-2015

Mailing address

827 E Division St
Cadillac, MI 49601-2015
Phone (231) 775-9741

Other identifiers 5

IdentifierTypeStateIssuer
0858317454OtherMIBLUE CROSS/SHIELD INDIVID
4752620MedicaidMI
141032OtherMIPREFERRED CHOICE ID NUMBE
P00149486OtherMIRAILROAD MEDICARE
0H36303OtherMIBLUE CROSS/SHIELD GROUP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050629001134 MI Practitioner - Family Practice 2567408552 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Practice of Cadillac PCGroup PAC ID 8123094414, 6 clinicians

Practice addresses (Care Compare)

827 E Division St
Cadillac, MI 49601-2015
Phone (231) 775-9741

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP014907MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Practice of Cadillac PC Family Medicine CurrentSince Jul 1, 2005 Accepting new patients

Locations

827 E Division St
Cadillac, MI 49601
Phone (231) 775-9741

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GDEIBA
  • Direct secure messaging: brandon.peltier@fpoc.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480550400000",
    "number": "1679566863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "827 E DIVISION ST",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496012015",
            "telephone_number": "231-775-9741",
            "fax_number": "231-775-9333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "827 E DIVISION ST",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496012015",
            "telephone_number": "231-775-9741",
            "fax_number": "231-775-9333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELTIER",
        "first_name": "BRANDON",
        "middle_name": "C",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2016-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "BP014907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/SHIELD INDIVID",
            "identifier": "0858317454",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4752620",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CHOICE ID NUMBE",
            "identifier": "141032",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00149486",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/SHIELD GROUP",
            "identifier": "0H36303",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cadillac, MI

Sources for this page

Verify at the official NPI Registry.