Martin Mitchell Pevzner, M.D,

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

4301029995 Issued in MI

Practice address

32270 Telegraph Rd
Suite 120
Bingham Farms, MI 48025-2456

Phone

(248) 646-1965

Fax

(248) 594-7158

NPI assigned

Oct 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Martin M Pevzner Professional name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477267200000",
    "number": "1942390976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32270 TELEGRAPH RD",
            "address_2": "SUITE 120",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480252456",
            "telephone_number": "248-646-1965",
            "fax_number": "248-594-7158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32270 TELEGRAPH RD",
            "address_2": "SUITE 120",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480252456",
            "telephone_number": "248-646-1965",
            "fax_number": "248-594-7158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEVZNER",
        "first_name": "MARTIN",
        "middle_name": "MITCHELL",
        "name_prefix": "Dr.",
        "credential": "M.D,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2016-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MI",
            "license": "4301029995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "15748575",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARTIN",
            "last_name": "PEVZNER",
            "middle_name": "M",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jada Nicole Peterson
• Rachel Ann Peterson, T-LLP
• Danielle Nicole Petras
• Suraya Petty
• Sierra Marie Petzold
• Bianca Phillips
• Carlos Samuel Leon Phillips
• Katelynn Phillips
• Madison Phillips
• Shelby Nicole Phillips

• Rheumatology Physician in Bingham Farms, MI
• Providers in Bingham Farms, MI by specialty
• Rheumatology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.