Active NPI
William Paul Penn, D.O.
- Family Medicine Physician
- Livonia, MI
National Provider Identifier
1740287812
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 00594
- Practice address
- 9460 Middlebelt Rd
Livonia, MI 48150-3042 - Phone
- (734) 425-0780
- Fax
- (734) 425-1002
- NPI assigned
- Jul 5, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 00594 | MI | Primary |
Addresses
Primary practice location
9460 Middlebelt Rd
Livonia, MI 48150-3042
Mailing address
9460 Middlebelt Rd
Livonia, MI 48150-3042
Phone (734) 425-0780
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5822444 | Other | MI | BLUE PREF. PLUS PPO |
| 081045005 | Other | RAILROAD MEDICARE | |
| 25872 | Other | MI | OMNI CARE |
| 2791058 | Medicaid | MI | |
| 108151 | Other | MI | MERCY CARE CHOICES |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Midwestern University, Chicago College of Osteopathic Med, 1968
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
9460 Middlebelt Rd
Livonia, MI 48150-3059
Phone (734) 425-0500
Hospital & facility affiliations
- Beaumont Home Health
- Beaumont Hospital - Farmington Hills
- Corewell Health Wayne Hospital
- Garden City Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00594 | MI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Group Practice, P.C. | Family Medicine | Current | Accepting new patients |
Locations
9460 Middlebelt Rd
Livonia, MI 48150
Phone (313) 425-0500
Interoperability endpoints
- wpenn1144275@direct.hfhs.org
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Livonia, MI
- NPI 1801925201
Hospital & facility affiliations 11
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Troy, MI
- NPI 1811461734
-
- General Acute Care Hospital
- Farmington Hills, MI
- NPI 1336183367
-
- General Acute Care Hospital
- Wayne, MI
- NPI 1295785285
-
- General Acute Care Hospital
- Garden City, MI
- NPI 1043625940
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1258588800000",
"number": "1740287812",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9460 MIDDLEBELT RD",
"city": "LIVONIA",
"state": "MI",
"postal_code": "481503042",
"telephone_number": "734-425-0780",
"fax_number": "734-425-1002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9460 MIDDLEBELT RD",
"city": "LIVONIA",
"state": "MI",
"postal_code": "481503042",
"telephone_number": "734-425-0780",
"fax_number": "734-425-1002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENN",
"first_name": "WILLIAM",
"middle_name": "PAUL",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-05",
"last_updated": "2009-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "00594",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE PREF. PLUS PPO",
"identifier": "5822444",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "081045005",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OMNI CARE",
"identifier": "25872",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2791058",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MERCY CARE CHOICES",
"identifier": "108151",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Livonia, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2009; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.