Active NPI
David Pegouske, M.D.
- Dermatology Physician
- Livonia, MI
National Provider Identifier
1932201183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 4301070087
- Practice address
- 14801 Farmington Rd
Livonia, MI 48154 - Phone
- (734) 542-8100
- Fax
- (734) 542-8168
- NPI assigned
- Sep 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 4301070087 | MI | Primary |
Addresses
Primary practice location
14801 Farmington Rd
Livonia, MI 48154
Mailing address
14801 Farmington Rd
Livonia, MI 48154
Phone (734) 542-8100
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C7845 | Other | MI | M-CARE OF MICHIGAN |
| 6180642 | Other | MI | CIGNA |
| 5479258 | Other | MA | CNN FIRST HEALTH |
| 133931 | Other | MI | CARE CHOICES |
| 6180642003 | Other | MI | CHANDLER PHS |
| H36350 | Other | MI | HAP INSURANCE |
| 0708217311 | Other | MI | BCBSM |
| 12005406 | Other | MI | MULTIPLAN |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Dermatology
- Education
- Wayne State University School of Medicine, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
14801 Farmington Rd
Livonia, MI 48154-5429
Phone (734) 542-8100
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 55 of 100
- Quality
- 10
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of skin lesions | 310 |
| Removal of skin cancer | 129 |
| Skin biopsy | 93 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301070087 | MI | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Livonia Dermatology PLLC | Dermatology | Current | Accepting new patients |
Locations
14801 Farmington Rd
Livonia, MI 48154
Phone (313) 444-0064
15160 Levan Rd
Livonia, MI 48154
Phone (734) 462-0090
Organizations & group practices 1
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.
-
- Dermatology Physician
- Livonia, MI
- NPI 1457406217
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Farmington Hills, MI
- NPI 1336183367
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323388800000",
"number": "1932201183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14801 FARMINGTON RD",
"city": "LIVONIA",
"state": "MI",
"postal_code": "48154",
"telephone_number": "734-542-8100",
"fax_number": "734-542-8168"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14801 FARMINGTON RD",
"city": "LIVONIA",
"state": "MI",
"postal_code": "48154",
"telephone_number": "734-542-8100",
"fax_number": "734-542-8168"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEGOUSKE",
"first_name": "DAVID",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-01",
"last_updated": "2011-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "MI",
"license": "4301070087",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "M-CARE OF MICHIGAN",
"identifier": "C7845",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "6180642",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CNN FIRST HEALTH",
"identifier": "5479258",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARE CHOICES",
"identifier": "133931",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHANDLER PHS",
"identifier": "6180642003",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HAP INSURANCE",
"identifier": "H36350",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSM",
"identifier": "0708217311",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MULTIPLAN",
"identifier": "12005406",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Livonia, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.