Individual provider Active NPI

Jhonny Walter Perusina Banos, MD

  • Family Medicine Physician
  • Pontiac, MI
National Provider Identifier
1922848324
Registry record updated Jan 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4351053223 Issued in MI
Practice address
461 W Huron St Ste 107
Pontiac, MI 48341-1601
Phone
(248) 724-7600
Fax
(248) 724-6800
NPI assigned
May 31, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4351053223 MI Primary

Addresses

Primary practice location

461 W Huron St Ste 107
Pontiac, MI 48341-1601

Mailing address

PO Box 430150
Pontiac, MI 48343-0150
Phone (248) 724-7600

Other practice location 1

1200 N Telegraph Rd Dept 34E
Pontiac, MI 48341-1032
Phone (248) 724-7600

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jhonny.perusina.p1@direct.oihn.nextgenshare.com

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
I20240727000258 MI Practitioner - Family Practice 3072059955 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Oakland Integrated Healthcare Network CurrentSince Jul 1, 2024 Accepting new patients
Oakland Integrated Healthcare Network CurrentSince Jul 1, 2024 Accepting new patients
County of Oakland Past Accepting new patients

Locations

461 W Huron St
Ste 107
Pontiac, MI 48341
Phone (248) 857-7432

1200 N Telegraph Rd
#87
Pontiac, MI 48341
Phone (248) 724-7435

1200 N Telegraph Rd
Dept 34
Pontiac, MI 48341
Phone (248) 858-1280

1200 N Telegraph Rd
Bldg 34E
Pontiac, MI 48341
Phone (248) 858-1276

Organizations & group practices 3

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": "1717113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769472000000",
    "number": "1922848324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 430150",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483430150",
            "telephone_number": "248-724-7600",
            "fax_number": "248-724-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 W HURON ST STE 107",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483411601",
            "telephone_number": "248-724-7600",
            "fax_number": "248-724-6800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 N Telegraph Rd Dept 34E",
            "address_purpose": "LOCATION",
            "city": "Pontiac",
            "state": "MI",
            "postal_code": "483411032",
            "country_code": "US",
            "telephone_number": "248-724-7600",
            "fax_number": "248-724-6800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERUSINA BANOS",
        "first_name": "JHONNY",
        "middle_name": "WALTER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-31",
        "last_updated": "2026-01-27",
        "certification_date": "2026-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4351053223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jhonny.perusina.p1@direct.oihn.nextgenshare.com",
            "affiliation": "N",
            "address_1": "461 W Huron St Ste 107",
            "city": "Pontiac",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483411601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

Verify at the official NPI Registry.