Individual provider Active NPI

Samuel Perov, M.D.

  • Specialist
  • Detroit, MI
National Provider Identifier
1740221522
Registry record updated Aug 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
4301043383
Practice address
4160 John R St
Detroit, MI 48201-2021
Phone
(313) 833-8467
NPI assigned
Jun 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 4301043383 Primary

Addresses

Primary practice location

4160 John R St
Detroit, MI 48201-2021

Mailing address

4160 John R St
Suite 522
Detroit, MI 48201-2020

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20041207000170 MI Practitioner - AnesthesiologyPractitioner - Interventional Pain Management 6901719269 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Interventional Pain Management
Education
Other, 1968
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elite Medical Rehabilitation Group IncGroup PAC ID 8729979281, 3 clinicians
Northstar Anesthesia of Michigan PLLCGroup PAC ID 9638481591, 192 clinicians

Practice addresses (Care Compare)

30500 Northwestern Hwy
Suite 316C
Farmington Hills, MI 48334-3178
Phone (248) 539-8781

4201 Saint Antoine St
Detroit, MI 48201-2153
Phone (313) 745-3615

Hospital & facility affiliations

  • Detroit Receiving Hospital Hospital, Detroit, MI, CCN 230273
  • Harper University Hospital Hospital, Detroit, MI, CCN 230104
  • Karmanos Cancer Center Hospital, Detroit, MI, CCN 230297

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Michigan PLLC CurrentSince Jun 1, 2015 Accepting new patients

Locations

4201 Saint Antoine St
Detroit, MI 48201
Phone (313) 745-3615

6071 W Outer Dr
Detroit, MI 48235
Phone (313) 966-3300

3990 John R St
Detroit, MI 48201
Phone (313) 745-6211

6225 State Highway 161
Ste 200
Irving, TX 75038
Phone (214) 687-0496

Interoperability endpoints

  • Direct secure messaging: sperov@direct.dmc.org

Organizations & group practices 2

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 3

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": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346284800000",
    "number": "1740221522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4160 JOHN R ST",
            "address_2": "SUITE 522",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 JOHN R ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012021",
            "telephone_number": "313-833-8467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEROV",
        "first_name": "SAMUEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2012-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": "4301043383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.