NPIMap

Individual provider Active NPI

Michelle Pedersen, D.O.

  • Internal Medicine Physician
  • Garden City, MI
National Provider Identifier
1700260601
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5101023585 Issued in MI
Practice address
6245 Inkster Rd
Garden City, MI 48135-4001
Phone
(734) 458-4319
NPI assigned
Jul 10, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5101023585 MI Primary

Addresses

Primary practice location

6245 Inkster Rd
Garden City, MI 48135-4001

Mailing address

6245 Inkster Rd
Garden City, MI 48135-4001
Phone (734) 458-4319

Other practice location 1

700 Hawk Ridge Dr
Hamburg, PA 19526-9219
Phone (610) 562-3066

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20200723001177 PA Practitioner - Internal Medicine 0446558431 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Temple Faculty Practice Plan IncGroup PAC ID 0345588711, 1,325 clinicians

Practice addresses (Care Compare)

333 Cottman Ave
Philadelphia, PA 19111-2434
Phone (215) 707-2111

Hospital & facility affiliations

  • Hospital of the Fox Chase Cancer Center Hospital, Philadelphia, PA, CCN 390196
  • Temple University Hospital Hospital, Philadelphia, PA, CCN 390027

Merit-based Incentive Payment System (MIPS)

Final score
81.21 of 100Reported as group
Quality
49.71
Promoting interoperability
100
Improvement activities
40
Cost
74.23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101023585MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Faculty Practice Plan Inc Current Accepting new patients
Chestnut Hill Clinic Company, LLC Internal Medicine CurrentSince Jul 20, 2020 Accepting new patients
Tower Health Medical Group Internal Medicine CurrentSince Jul 20, 2020 Accepting new patients
Temple Faculty Practice Plan, Inc CurrentSince Sep 20, 2024 Accepting new patients
Phoenixville Clinic Company LLC CurrentSince Jul 20, 2020 Accepting new patients
Chestnut Hill Clinic Company, LLC CurrentSince Jul 20, 2020 Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Sep 20, 2024 Accepting new patients
Phoenixville Clinic Company LLC CurrentSince Jul 20, 2020 Accepting new patients
Tower Health Medical Group CurrentSince Jul 20, 2020 Accepting new patients
Pottstown Clinic Company LLC Internal Medicine CurrentSince Jul 20, 2020 Accepting new patients
American Oncologic Hospital Past Accepting new patients

Locations

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

333 Cottman Ave
Philadelphia, PA 19111
Phone (215) 728-3893

8835 Germantown Ave
Philadelphia, PA 19118
Phone (215) 248-8227

140 Nutt Rd
Phoenixville, PA 19460
Phone (610) 983-1000

1600 E High St
Pottstown, PA 19464
Phone (610) 327-7485

730 S Hanover St
Pottstown, PA 19465
Phone (610) 323-6835

201 Reeceville Rd
West Brandywine, PA 19320
Phone (215) 788-2285

301 S 7th Ave
Ste 130
West Reading, PA 19611
Phone (610) 988-4630

420 S 5th Ave
West Reading, PA 19611
Phone (484) 628-3637

8200 Flourtown Ave
Ste 2
Wyndmoor, PA 19038
Phone (215) 836-5100

2610 Keiser Blvd
Wyomissing, PA 19610
Phone (484) 628-9127

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.

Hospital & facility affiliations 9

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": "1436486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1700260601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6245 INKSTER RD",
            "city": "GARDEN CITY",
            "state": "MI",
            "postal_code": "481354001",
            "telephone_number": "734-458-4319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6245 INKSTER RD",
            "city": "GARDEN CITY",
            "state": "MI",
            "postal_code": "481354001",
            "telephone_number": "734-458-4319"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 Hawk Ridge Dr",
            "address_purpose": "LOCATION",
            "city": "Hamburg",
            "state": "PA",
            "postal_code": "195269219",
            "country_code": "US",
            "telephone_number": "610-562-3066",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "MICHELLE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-10",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101023585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, MI

Sources for this page

Verify at the official NPI Registry.