Active NPI
Edward Peszko, DO
- Hospitalist Physician
- West Branch, MI
National Provider Identifier
1972773695
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- 5101007045
- Practice address
- 307 East Houghton Ave
West Branch, MI 48661-1127 - Phone
- (989) 345-8008
- Fax
- (989) 345-8803
- NPI assigned
- Mar 10, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | 5101007045 | MI | Primary |
Addresses
Primary practice location
307 East Houghton Ave
West Branch, MI 48661-1127
Mailing address
307 East Houghton Ave
West Branch, MI 48661-1127
Phone (989) 345-8008
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101007045 | MI | MD | Hospitalist Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205107200000",
"number": "1972773695",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "307 EAST HOUGHTON AVE",
"city": "WEST BRANCH",
"state": "MI",
"postal_code": "486611127",
"telephone_number": "989-345-8008",
"fax_number": "989-345-8803"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "307 EAST HOUGHTON AVE",
"city": "WEST BRANCH",
"state": "MI",
"postal_code": "486611127",
"telephone_number": "989-345-8008",
"fax_number": "989-345-8803"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PESZKO",
"first_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-03-10",
"last_updated": "2008-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "MI",
"license": "5101007045",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Branch, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2008; 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.