Individual provider Active NPI

Peter Gerrits

  • Pediatric Endocrinology Physician
  • Royal Oak, MI
National Provider Identifier
1871553909
Registry record updated Oct 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
4301062337 Issued in MI
Practice address
3535 W 13 Mile Rd
Ste. 707
Royal Oak, MI 48073-6710
Phone
(248) 551-0487
NPI assigned
Mar 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology Physician 2080P0205X 4301062337 MI Primary

Addresses

Primary practice location

3535 W 13 Mile Rd
Ste. 707
Royal Oak, MI 48073-6710

Mailing address

130 Town Center Dr Ste 203
Beaumont Medical Staff Affairs
Troy, MI 48084-1744

Other identifiers 2

IdentifierTypeStateIssuer
2958733MedicaidMI
350F361320OtherMIBCBSM

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pgerrits8479@direct.beaumont.edu

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
I20041006000187 MI Practitioner - Pediatric MedicinePractitioner - Endocrinology 4688633670 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.37 of 100Reported as group
Quality
66.73
Promoting interoperability
100
Improvement activities
40
Cost
70.98

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health St. John Hospital Current Accepting new patients
William Beaumont Hospital CurrentSince Nov 1, 2012 Accepting new patients
Beaumont Medical Group- Specialty Services CurrentSince Mar 21, 2018 Accepting new patients
Henry Ford Health St. John Hospital CurrentSince Nov 2, 2013 Accepting new patients
William Beaumont Hospital Current Accepting new patients
Henry Ford Health St. John Hospital CurrentSince Nov 2, 2013 Accepting new patients
Pathology Specialists of Southeast Michigan PC Current Accepting new patients
William Beaumont Hospital CurrentSince Nov 1, 2012 Accepting new patients

Locations

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

28100 Grand River Ave
Ste 301
Farmington Hills, MI 48336
Phone (947) 521-1320

3535 W 13 Mile Rd
Royal Oak, MI 48073
Phone (248) 551-1010

3535 W 13 Mile Rd
Ste 707
Royal Oak, MI 48073
Phone (248) 551-0487

26001 Jefferson Ave
Saint Clair Shores, MI 48081
Phone (586) 779-7000

44199 Dequindre Rd
Ste 103
Troy, MI 48085
Phone (248) 964-9220

130 Town Center Dr
Ste 203
Troy, MI 48084
Phone (248) 585-8250

Interoperability endpoints

  • Direct secure messaging: pgerrits8479@direct.beaumont.edu
  • Direct secure messaging: pgerrits1129890@direct.hfhs.org
  • Direct secure messaging: pgerrits293457@epic00.shdirect.org

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1871553909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 TOWN CENTER DR STE 203",
            "address_2": "BEAUMONT MEDICAL STAFF AFFAIRS",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480841744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 W 13 MILE RD",
            "address_2": "STE. 707",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736710",
            "telephone_number": "248-551-0487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERRITS",
        "first_name": "PETER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "MI",
            "license": "4301062337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2958733",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "350F361320",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pgerrits8479@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "3535 W 13 Mile Rd",
            "address_2": "Ste. 707",
            "city": "Royal Oak",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480736710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.