Individual provider Active NPI

Dominic A. Perrotta, MD

  • Emergency Medicine Physician
  • Ypsilanti, MI
National Provider Identifier
1952389637
Registry record updated Nov 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
15083R Issued in LA
Practice address
5301 E Huron River Dr
Ypsilanti, MI 48197-1051
Phone
(734) 712-3001
Fax
(734) 712-7388
NPI assigned
Jan 4, 2006
Last updated
Nov 5, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 15083R LA Primary

Addresses

Primary practice location

5301 E Huron River Dr
Ypsilanti, MI 48197-1051

Mailing address

5301 E Huron River Dr
Ypsilanti, MI 48197-1051
Phone (734) 712-3001

Other identifiers 1

IdentifierTypeStateIssuer
1551236MedicaidLA

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
I20070927000377 MI Practitioner - Emergency Medicine 5193749000 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Michigan Medical School, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Epmg of Michigan PCGroup PAC ID 4789596339, 108 clinicians

Practice addresses (Care Compare)

5301 McAuley Dr
Ypsilanti, MI 48197-1051
Phone (954) 939-5000

775 S Main St
Chelsea, MI 48118-1383
Phone (954) 939-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15083RLAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Physicians Medical Group of Michigan, PC Emergency Medicine CurrentSince Oct 15, 2023 Accepting new patients
Saint Joseph Mercy Livingston Hospital CurrentSince Apr 17, 2017 Accepting new patients
St Joseph Mercy Hospital Emergency Medicine CurrentSince Dec 26, 2018 Accepting new patients
Saint Joseph Mercy Livingston Hospital Emergency Medicine CurrentSince Apr 17, 2017 Accepting new patients
Epmg of Michigan, P.C. Emergency Medicine CurrentSince Aug 1, 2007 Accepting new patients
Hospitalist Physicians Medical Group of Michigan, PC Emergency Medicine CurrentSince Oct 15, 2023 Accepting new patients
St Joseph Mercy Hospital Current Accepting new patients
St Joseph Mercy Hospital CurrentSince Dec 26, 2018 Accepting new patients
Willis Knighton Medical Center, Inc. WK Emergency Dept Group Emergency Medicine Past Accepting new patients

Locations

1600 S Canton Center Rd
Canton, MI 48188
Phone (734) 398-7557

775 S Main St
Chelsea, MI 48118
Phone (313) 995-3764

620 Byron Rd
Howell, MI 48843
Phone (517) 545-5450

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

5301 McAuley Dr
Ypsilanti, MI 48197
Phone (734) 712-7246

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 2

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": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194220800000",
    "number": "1952389637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 E HURON RIVER DR",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971051",
            "telephone_number": "734-712-3001",
            "fax_number": "734-712-7388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 E HURON RIVER DR",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971051",
            "telephone_number": "734-712-3001",
            "fax_number": "734-712-7388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERROTTA",
        "first_name": "DOMINIC",
        "middle_name": "A.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-04",
        "last_updated": "2007-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "15083R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1551236",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.