Individual provider Active NPI

Peter Demetrios Panagopoulos, M.D.

  • Anesthesiology Physician
  • Grosse Pointe Woods, MI
National Provider Identifier
1710116611
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
4301093014 Issued in MI
Practice address
639 Canterbury Rd
Grosse Pointe Woods, MI 48236-1282
Phone
(313) 881-2106
NPI assigned
Jul 13, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 4301093014 MI Primary

Addresses

Primary practice location

639 Canterbury Rd
Grosse Pointe Woods, MI 48236-1282

Mailing address

639 Canterbury Rd
Grosse Pointe Woods, MI 48236-1282

Other practice location 1

6245 Inkster Rd
Garden City, MI 48135-4001
Phone (248) 423-5198

Other practice location 2

3330 Meijer Dr Ste 2
Toledo, OH 43617-3103
Phone (419) 578-2020

Other practice location 3

4235 Secor Rd
Toledo, OH 43623-4299
Phone (419) 214-4214

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, OH2 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
I20120730000677 MI Practitioner - Anesthesiology 1658537022 Reassigns benefits to 4 organizations
I20260608002028 OH Practitioner - Anesthesiology 1658537022 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St John Anesthesiologists, PCGroup PAC ID 5799747283, 21 clinicians

Practice addresses (Care Compare)

22101 Moross Rd
Detroit, MI 48236-2148
Phone (313) 343-4000

Hospital & facility affiliations

  • Henry Ford Health St John Hospital Hospital, Detroit, MI, CCN 230165

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301093014MIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St John Anesthesiologists, PC Anesthesiology CurrentSince Nov 1, 2025 Accepting new patients
Northstar Anesthesia of Michigan III PLLC CurrentSince Aug 20, 2020 Accepting new patients

Locations

18101 Oakwood Blvd
Dearborn, MI 48124
Phone (313) 593-8780

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

4100 S River Rd
East China, MI 48054
Phone (810) 329-6677

33155 Annapolis St
Wayne, MI 48184
Phone (734) 467-4042

Organizations & group practices 5

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 1

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": "1247443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1710116611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "639 CANTERBURY RD",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482361282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "639 CANTERBURY RD",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482361282",
            "telephone_number": "313-881-2106"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6245 Inkster Rd",
            "address_purpose": "LOCATION",
            "city": "Garden City",
            "state": "MI",
            "postal_code": "481354001",
            "country_code": "US",
            "telephone_number": "248-423-5198",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3330 Meijer Dr Ste 2",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436173103",
            "country_code": "US",
            "telephone_number": "419-578-2020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4235 Secor Rd",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436234299",
            "country_code": "US",
            "telephone_number": "419-214-4214",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANAGOPOULOS",
        "first_name": "PETER",
        "middle_name": "DEMETRIOS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-13",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301093014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grosse Pointe Woods, MI

Sources for this page

Verify at the official NPI Registry.