Peter G. Grain, M.D.

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

4301069603 Issued in MI

Practice address

2603 Electric Ave
Suite a
Port Huron, MI 48060-6588

Phone

(810) 987-1056

Fax

(810) 987-1060

NPI assigned

Jan 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Orthopedic Specialists of Oakland County, P.C.

  • Orthopaedic Surgery Physician
  • Bloomfield Hills, MI
  • NPI 1720200140
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262649600000",
    "number": "1780664573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2603 ELECTRIC AVE",
            "address_2": "SUITE A",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480606588",
            "telephone_number": "810-987-1056",
            "fax_number": "810-987-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2603 ELECTRIC AVE",
            "address_2": "SUITE A",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480606588",
            "telephone_number": "810-987-1056",
            "fax_number": "810-987-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAIN",
        "first_name": "PETER",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2010-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MI",
            "license": "4301069603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103409558",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HEALTH PLANS",
            "identifier": "0580808",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "M-CARE",
            "identifier": "15231",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE PLAN",
            "identifier": "D16645",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1406326922",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00171032",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104604735",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLUS OF MICHIGAN",
            "identifier": "0999859",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janet Louise Grace, LMSW
• Jimmy Graham
• Khalida M. Graham, MSN, FNP-C
• Shelby Renee Graham
• Sherry Graham
• Joshua Grattan, PHARM. D.
• Adam Gray, MS, CCC-SLP
• Lisa Gray, LPC
• Rene S Gray
• Great Lakes Anesthesia, PLC

• Neurological Surgery Physician in Port Huron, MI
• Providers in Port Huron, MI by specialty
• Neurological Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.