NPIMap

Individual provider Active NPI

Andi Peshkepija, M.D.

  • Vascular Surgery Physician
  • Detroit, MI
National Provider Identifier
1912347279
Registry record updated May 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
4301501902 Issued in MI
Practice address
2799 W Grand Blvd # K8
Detroit, MI 48202-2608
Phone
(800) 436-7936
NPI assigned
Jul 1, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2086S0129X 4301501902 MI Primary

Addresses

Primary practice location

2799 W Grand Blvd # K8
Detroit, MI 48202-2608

Mailing address

1200 E Michigan Ave Ste 655
Lansing, MI 48912-1837
Phone (517) 267-2460

Other practice location 1

2333 Biddle Ave Ste 1A500
Wyandotte, MI 48192-4668
Phone (800) 436-7936

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
I20200401000759 MI Practitioner - Vascular SurgeryPractitioner - General Surgery 1951651629 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
Michigan State University College of Human Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

2333 Biddle Ave
Wyandotte, MI 48192-4668
Phone (734) 246-6064

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)25
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Single Specialty CurrentSince Mar 1, 2020 Accepting new patients
Henry Ford Pathology Single Specialty Current Accepting new patients
Henry Ford Health System Single Specialty Current Accepting new patients
Henry Ford Health System CurrentSince Mar 1, 2020 Accepting new patients
Henry Ford Maplegrove Center Past Accepting new patients

Locations

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

2799 W Grand Blvd
#K8
Detroit, MI 48202
Phone (313) 916-1755

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

2799 W Grand Blvd
#363
Detroit, MI 48202
Phone (313) 916-2020

6777 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 325-1000

2333 Biddle Ave
Wyandotte, MI 48192
Phone (734) 246-6000

2333 Biddle Ave
Ste 1A500
Wyandotte, MI 48192

Interoperability endpoints

  • Direct secure messaging: apeshkepija382899@direct.hfhs.org

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 7

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": "1372636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588723200000",
    "number": "1912347279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E MICHIGAN AVE STE 655",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121837",
            "telephone_number": "517-267-2460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD # K8",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "800-436-7936"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2333 Biddle Ave Ste 1A500",
            "address_purpose": "LOCATION",
            "city": "Wyandotte",
            "state": "MI",
            "postal_code": "481924668",
            "country_code": "US",
            "telephone_number": "800-436-7936",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PESHKEPIJA",
        "first_name": "ANDI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-01",
        "last_updated": "2020-05-06",
        "certification_date": "2020-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "MI",
            "license": "4301501902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.