Gregory G Montpetit, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

GM048923 Issued in MI

Practice address

25599 Kelly Rd
Suite B
Roseville, MI 48066-4975

Phone

(586) 445-2330

Fax

(586) 445-2352

NPI assigned

Jul 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304294400000",
    "number": "1699790626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25599 KELLY RD",
            "address_2": "SUITE B",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480664975",
            "telephone_number": "586-445-2330",
            "fax_number": "586-445-2352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25599 KELLY RD",
            "address_2": "SUITE B",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480664975",
            "telephone_number": "586-445-2330",
            "fax_number": "586-445-2352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTPETIT",
        "first_name": "GREGORY",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2011-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "GM048923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2708570",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "GM048923",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110042849",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1105017111",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathrine Mobisson III, M.D.
• Modern Alchemy Mental Health and Wellness PLLC
• Mohammad Sunbulli MD PLLC
• Sabah M Mohammed, MD
• John Montoni, D.P.M.
• Michael Joseph Mooney, MA,LLP,CAC,CCS,CCJP
• Andrew William James Moore, DO
• Donald R Moore, M.D.
• Douglas R Moore, D.O.
• Gennea Nickole Moore, LLP

• Internal Medicine Physician in Roseville, MI
• Providers in Roseville, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.