Individual provider Active NPI

Robin Theresa Petroze, MD

  • Pediatric Surgery Physician
  • Ann Arbor, MI
National Provider Identifier
1699935007
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
4301510543 Issued in MI
Practice address
1500 E Medical Center Dr
Ann Arbor, MI 48109-5000
Phone
(734) 936-4000
NPI assigned
Jun 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Surgery Physician 2086S0120X ME137818 FL
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Surgery Physician 2086S0120X 4301510543 MI Primary

Addresses

Primary practice location

1500 E Medical Center Dr
Ann Arbor, MI 48109-5000

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

Other practice location 1

1600 SW Archer Rd
Gainesville, FL 32610-0119
Phone (352) 273-8825

Other identifiers 1

IdentifierTypeStateIssuer
101058400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181112001656 FL Practitioner - General Surgery 6002045846 Reassigns benefits to 1 organization
I20240201000396 MI Practitioner - Pediatric MedicinePractitioner - General Surgery 6002045846 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME137818FLMDPediatric Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince Oct 1, 2018 Accepting new patients
Regents of the University of Michigan Pediatric Surgery CurrentSince Dec 10, 2023 Accepting new patients
Regents of the University of Michigan CurrentSince Dec 10, 2023 Accepting new patients
SJMH Medical Practice-SMHC CurrentSince Feb 1, 2024 Accepting new patients
Edward W Sparrow Hospital Association CurrentSince Dec 13, 2023 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Oct 1, 2018 Accepting new patients
Edward W. Sparrow Hospital Association Pediatric Surgery CurrentSince Dec 13, 2023 Accepting new patients
SJMH Medical Practice-SMHC CurrentSince Feb 1, 2024 Accepting new patients
Regents of the University of Michigan Current Accepting new patients
Edward W. Sparrow Hospital Association Past Accepting new patients
Regents of the University of Michigan Past Accepting new patients

Locations

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

8175 Reliable Pkwy
Chicago, IL 60686

1500 E Medical Center Dr
Fl 4
Ann Arbor, MI 48109
Phone (734) 763-9259

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

1500 E Medical Center Dr
#D
Ann Arbor, MI 48109
Phone (734) 936-5823

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

1200 E Michigan Ave
Ste 460
Lansing, MI 48912
Phone (517) 364-2097

1140 E Michigan Ave
Ste 300
Lansing, MI 48912
Phone (517) 364-5200

20555 Victor Pkwy
Livonia, MI 48152
Phone (734) 343-3925

44405 Woodward Ave
Pontiac, MI 48341
Phone (248) 858-3000

Interoperability endpoints

  • Direct secure messaging: rpetroze3280479@direct.trinity-health.org

Organizations & group practices 11

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": "1213056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1699935007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095000",
            "telephone_number": "734-936-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 SW Archer Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326100119",
            "country_code": "US",
            "telephone_number": "352-273-8825",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETROZE",
        "first_name": "ROBIN",
        "middle_name": "THERESA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-10",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "FL",
            "license": "ME137818",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "MI",
            "license": "4301510543",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101058400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.