Individual provider Active NPI

Peter John Kelterborn, D.O.

  • Internal Medicine Physician
  • Ann Arbor, MI
National Provider Identifier
1972948420
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5101026397 Issued in MI
Practice address
375 Briarwood Cir
Ann Arbor, MI 48108-1605
Phone
(734) 998-2020
NPI assigned
May 9, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X O-0949 ID
Internal Medicine Physician 207R00000X 5101026397 MI Primary

Addresses

Primary practice location

375 Briarwood Cir
Ann Arbor, MI 48108-1605

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

Other practice location 1

30410 Highway 200
Ponderay, ID 83852-9601
Phone (208) 265-6252

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
I20211230000597 MI Practitioner - Internal Medicine 3779893888 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Michigan State University College of Osteopathic Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1500 E Medical Ctr
Suite 0331
Ann Arbor, MI 48109-0999
Phone (734) 936-5738

1500 E Medical Ctr 2ND Floor Rec
Taubman Center
Ann Arbor, MI 48109-0999
Phone (734) 936-5020

1500 E Medical Ctr Dr
Ann Arbor, MI 48109-0999

1500 E Medical Ctr Dr
Ann Arbor, MI 48109-5000

1500 E Medical Ctr Dr 1St FL
Taubman Ctr Rec D
Ann Arbor, MI 48109-5000
Phone (734) 936-4185

1500 E Medical Ctr Dr 1St FL Rec D
Taubman Center
Ann Arbor, MI 48109-5000
Phone (734) 764-5175

1500 E Medical Ctr Dr 1St FL Rec F
Mott Hospital
Ann Arbor, MI 48109-5000
Phone (734) 764-5176

1500 E Medical Ctr Dr 1St Flo
Ann Arbor, MI 48109-0999

1500 E Medical Ctr Dr 1St Floor
Ann Arbor, MI 48109-0999

1500 E Medical Ctr Dr 2ND LR
Med Inn
Ann Arbor, MI 48109-0999
Phone (734) 763-5459

1500 E Medical Ctr Dr 3Rd FL Taubma
Ann Arbor, MI 48109-5000
Phone (734) 647-7321

1500 E Medical Ctr Dr B2 Floor R
Cancer and Geriatrics Center
Ann Arbor, MI 48109-0999
Phone (734) 936-6274

1500 E Medical Ctr Dr Level B
Cancer and Geriatrics Center
Ann Arbor, MI 48109-0999
Phone (734) 647-8901

325 Briarwood Cir
Ann Arbor, MI 48108-1605
Phone (888) 287-1082

355 Briarwood Cir
Ann Arbor, MI 48108-1605
Phone (734) 998-7710

375 Briarwood Cir
Suite 3
Ann Arbor, MI 48108-1605
Phone (734) 998-7207

375 Briarwood Circle Building
Suite 3
Ann Arbor, MI 48108-1605
Phone (734) 998-7207

380 Parkland PLZ
Ann Arbor, MI 48103-6201
Phone (734) 998-7380

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
O-0949IDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan Internal Medicine CurrentSince Oct 26, 2021 Accepting new patients
Regents of the University of Michigan Internal Medicine Current Accepting new patients
Regents of the University of Michigan CurrentSince Oct 26, 2021 Accepting new patients

Locations

1500 E Medical Center Dr
Ann Arbor, MI 48109
Phone (734) 936-4280

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

375 Briarwood Cir
Ann Arbor, MI 48108
Phone (734) 998-7207

375 Briarwood Cir
Bldg 3
Ann Arbor, MI 48108
Phone (734) 998-7207

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.

Hospital & facility affiliations 1

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": "1368057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1972948420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 BRIARWOOD CIR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081605",
            "telephone_number": "734-998-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30410 Highway 200",
            "address_purpose": "LOCATION",
            "city": "Ponderay",
            "state": "ID",
            "postal_code": "838529601",
            "country_code": "US",
            "telephone_number": "208-265-6252",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELTERBORN",
        "first_name": "PETER",
        "middle_name": "JOHN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-09",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "O-0949",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101026397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.