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DOROTHY A PEDTKE D.O. NPI 1467453456


NPI Information

NPI: 1467453456
Provider Name: DOROTHY A PEDTKE, D.O.
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
Organization: BORN CLINIC PC

PECOS Registration: Yes

Address:
3700 52ND ST SE
GRAND RAPIDS, MI
ZIP 49512
Phone: (616) 656-3700
Get Directions

Dorothy A Pedtke, D.O. is a family medicine in Grand Rapids, MI with 25 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Dorothy A Pedtke, D.O. NPI is 1467453456. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Graduation Year:1999

The provider's business location address is:

3700 52ND ST SE
GRAND RAPIDS, MI
ZIP 49512-637
Phone: (616) 656-3700
Fax: (616) 656-3701

The NPI 1467453456 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Complete blood cell count (red cells, white blood cell, platelets), automated test (HCPCS:85025)
  • Cervical or vaginal cancer screening; pelvic and clinical breast examination (HCPCS:G0101)
  • Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory (HCPCS:Q0091)

The enumeration date for this NPI number is 8/2/2005 and was last updated on 7/8/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineDP014363MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1H64553MEDICARE UPINMICHIGAN
2D16227006MEDICARE ID-TYPE UNSPECIFIEDMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.