NPIMap

Individual provider Active NPI

Perjohan Persson, MD

  • Surgery Physician
  • Mt Pleasant, MI
National Provider Identifier
1912236902
Registry record updated Dec 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
43219 Issued in KY
Practice address
1201 South Dr
Suite 371
Mt Pleasant, MI 48858-3256
Phone
(989) 953-4169
Fax
(989) 953-4153
NPI assigned
Dec 22, 2009
Last updated
Dec 14, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 43219 KY Primary

Addresses

Primary practice location

1201 South Dr
Suite 371
Mt Pleasant, MI 48858-3256

Mailing address

401 S Ballenger Hwy
Flint, MI 48532-3638
Phone (270) 692-9559

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, MI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100315000306 KY Practitioner - General Surgery 1658416557 Reassigns benefits to 1 organization
I20160908001044 MI Practitioner - General Surgery 1658416557 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Cincinnati College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren Central MichiganGroup PAC ID 6103733092, 183 clinicians

Practice addresses (Care Compare)

1201 S Dr
Mt Pleasant, MI 48858-3255

1221 S Dr
Mount Pleasant, MI 48858-3257
Phone (989) 772-6811

1221 S Dr Attn Cfo Administration
Mt Pleasant, MI 48858-3234

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy74
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux46
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Central Michigan Current Accepting new patients
Kentucky Mso LLC CurrentSince Jul 11, 2012 Accepting new patients
McLaren Central Michigan CurrentSince Aug 31, 2016 Accepting new patients
McLaren Central Michigan CurrentSince Aug 31, 2016 Accepting new patients
McLaren Central Michigan Past Accepting new patients
Northern Kentucky Center for Pain Relief, LLC Past Accepting new patients
McLaren Central Michigan Past Accepting new patients

Locations

401 S Ballenger Hwy
Flint, MI 48532
Phone (810) 342-1000

1201 South Dr
Ste 352
Mt Pleasant, MI 48858
Phone (989) 772-6880

1201 South Dr
Ste 371
Mt Pleasant, MI 48858
Phone (989) 953-4169

1221 South Dr
Mt Pleasant, MI 48858
Phone (989) 772-6700

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16584/brand/1/csg/1/fhir/r4

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
McLaren Central - Clare ClinicClare, MI, CCN 238727 Rural health clinic Corporate Director Feb 1, 2022
McLaren Northern Michigan - Cheboygan Community Medical CenterCheboygan, MI, CCN 238751 Rural health clinic Corporate Director Feb 1, 2022

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 9

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 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": "1261440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481673600000",
    "number": "1912236902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 S BALLENGER HWY",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323638",
            "telephone_number": "270-692-9559",
            "fax_number": "270-692-9236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 SOUTH DR",
            "address_2": "SUITE 371",
            "city": "MT PLEASANT",
            "state": "MI",
            "postal_code": "488583256",
            "telephone_number": "989-953-4169",
            "fax_number": "989-953-4153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSSON",
        "first_name": "PERJOHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-22",
        "last_updated": "2016-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KY",
            "license": "43219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, MI

Sources for this page

Verify at the official NPI Registry.