Individual provider Active NPI

Peter Kerr Henke, MD

  • Vascular Surgery Physician
  • Ann Arbor, MI
National Provider Identifier
1881794618
Registry record updated Jan 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
4301071742 Issued in MI
Practice address
1500 East Medical Center Dr
3Rd Floor Cardiovascular Center Recp B
Ann Arbor, MI 48109-5329
Phone
(734) 936-5850
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 4301071742 MI
Vascular Surgery Physician 2086S0129X 4301071742 MI Primary

Addresses

Primary practice location

1500 East Medical Center Dr
3Rd Floor Cardiovascular Center Recp B
Ann Arbor, MI 48109-5329

Mailing address

3621 S State St
700 KMS Place
Ann Arbor, MI 48108
Phone (734) 936-2047

Other identifiers 1

IdentifierTypeStateIssuer
4222802MedicaidMI

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
I20100104000641 MI Practitioner - Vascular SurgeryPractitioner - General Surgery 3678614245 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
University of Wisconsin School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1500 E Medical Ctr
Suite 0331
Ann Arbor, MI 48109-0999
Phone (734) 936-5738

1500 E Medical Ctr 2ND Floor Rec
Taubman Center
Ann Arbor, MI 48109-0999
Phone (734) 936-5020

1500 E Medical Ctr Dr
Ann Arbor, MI 48109-0999

1500 E Medical Ctr Dr
Ann Arbor, MI 48109-5000

1500 E Medical Ctr Dr 1St FL
Taubman Ctr Rec D
Ann Arbor, MI 48109-5000
Phone (734) 936-4185

1500 E Medical Ctr Dr 1St FL Rec D
Taubman Center
Ann Arbor, MI 48109-5000
Phone (734) 764-5175

1500 E Medical Ctr Dr 1St FL Rec F
Mott Hospital
Ann Arbor, MI 48109-5000
Phone (734) 764-5176

1500 E Medical Ctr Dr 1St Flo
Ann Arbor, MI 48109-0999

1500 E Medical Ctr Dr 1St Floor
Ann Arbor, MI 48109-0999

1500 E Medical Ctr Dr 2ND LR
Med Inn
Ann Arbor, MI 48109-0999
Phone (734) 763-5459

1500 E Medical Ctr Dr 3Rd FL Taubma
Ann Arbor, MI 48109-5000
Phone (734) 647-7321

1500 E Medical Ctr Dr B2 Floor R
Cancer and Geriatrics Center
Ann Arbor, MI 48109-0999
Phone (734) 936-6274

1500 E Medical Ctr Dr Level B
Cancer and Geriatrics Center
Ann Arbor, MI 48109-0999
Phone (734) 647-8901

7500 Challis Rd
Brighton, MI 48116-9416
Phone (810) 263-4000

8001 Challis Rd
Brighton, MI 48116-7446
Phone (810) 227-9510

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan Surgery CurrentSince Jul 11, 2000 Accepting new patients
Regents of the University of Michigan CurrentSince Jul 11, 2000 Accepting new patients
Regents of the University of Michigan Current Accepting new patients
Regents of the University of Michigan Past Accepting new patients

Locations

1500 E Medical Center Dr
#D
Ann Arbor, MI 48109
Phone (734) 936-5823

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

1500 E Medical Center Dr
Fl 3
Ann Arbor, MI 48109
Phone (734) 647-5944

3621 S State St
#700
Ann Arbor, MI 48108

8001 Challis Rd
Brighton, MI 48116
Phone (810) 227-9510

7500 Challis Rd
Brighton, MI 48116
Phone (734) 764-4190

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

39901 Traditions Dr
Northville, MI 48168
Phone (248) 305-4400

Interoperability endpoints

  • Direct secure messaging: phenke25995@direct.med.umich.edu

Organizations & group practices 5

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 1

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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326758400000",
    "number": "1881794618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "address_2": "700 KMS PLACE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48108",
            "telephone_number": "734-936-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 EAST MEDICAL CENTER DR",
            "address_2": "3RD FLOOR CARDIOVASCULAR CENTER RECP B",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095329",
            "telephone_number": "734-936-5850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENKE",
        "first_name": "PETER",
        "middle_name": "KERR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2012-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301071742",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MI",
            "license": "4301071742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4222802",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.