NPIMap

Individual provider Active NPI

Benedict P. Pellerito, M.D.

  • Orthopaedic Surgery Physician
  • Saint Clair Shores, MI
National Provider Identifier
1780655969
Registry record updated Feb 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
4301061624 Issued in MI
Practice address
24715 Little Mack Ave
Suite 100
St Clair Shores, MI 48080-3207
Phone
(586) 779-7970
Fax
(586) 779-7748
NPI assigned
Jan 27, 2006
Last updated
Feb 19, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 4301061624 MI Primary

Addresses

Primary practice location

24715 Little Mack Ave
Suite 100
St Clair Shores, MI 48080-3207

Mailing address

24715 Little Mack Ave
Suite 100
Saint Clair Shores, MI 48080-3207
Phone (586) 779-7970

Other names 1

  • Benedetto P. Pellerito Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20091228000185 MI Practitioner - Orthopedic Surgery 0648310581 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Semi Medical GroupGroup PAC ID 0648180406, shared by 4 NPIs, 246 clinicians

Practice addresses (Care Compare)

17900 23 Mile Rd
Macomb, MI 48044-1161
Phone (313) 647-3900

50505 Schoenherr Rd
Suite 120
Shelby Township, MI 48315-3140
Phone (586) 412-1411

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.14 of 100Reported as group
Quality
80.64
Promoting interoperability
100
Improvement activities
40
Cost
79.83

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement40
Lower limb (leg) arthroscopy (minimally invasive joint repair)11
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301061624MIMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Orthopedists of Detroit PC Orthopaedic Surgery CurrentSince Sep 1, 2001 Accepting new patients
Associated Orthopedists of Detroit, PC Orthopaedic Surgery CurrentSince Sep 1, 2001 Accepting new patients

Locations

50505 Schoenherr Rd
Ste 120
Shelby Township, MI 48315
Phone (586) 412-1411

24715 Little Mack Ave
St Clr Shores, MI 48080
Phone (586) 777-9000

24715 Little Mack Ave
Ste 100
St Clr Shores, MI 48080
Phone (586) 779-2585

Interoperability endpoints

  • Direct secure messaging: benedetto.pellerito.1@24034.direct.athenahealth.com
  • Direct secure messaging: benedettopellerito@aod.directglo.com
  • Direct secure messaging: bpellerito63385@direct.hfhs.org
  • FHIR API: https://api.platform.athenahealth.com/24034/brand/1/csg/1/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392768000000",
    "number": "1780655969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24715 LITTLE MACK AVE",
            "address_2": "SUITE 100",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480803207",
            "telephone_number": "586-779-7970",
            "fax_number": "586-779-7748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24715 LITTLE MACK AVE",
            "address_2": "SUITE 100",
            "city": "ST CLAIR SHORES",
            "state": "MI",
            "postal_code": "480803207",
            "telephone_number": "586-779-7970",
            "fax_number": "586-779-7748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLERITO",
        "first_name": "BENEDICT",
        "middle_name": "P.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2014-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "4301061624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BENEDETTO",
            "last_name": "PELLERITO",
            "middle_name": "P.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Saint Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.