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SACRED HEART PEDIATRICS
NPI 1053674184
Pediatrics in Grass Lake, MI

Active since June 22, 2012CLIA 23D1037775 · Waiver
11755 E MICHIGAN AVE, GRASS LAKE, MI 49240(517) 522-6100(517) 522-4715 Get Directions Write a Review

NPPES record last updated: June 22, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Sacred Heart Pediatrics NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SACRED HEART PEDIATRICS (NPI 1053674184) is a healthcare organization registered as a pediatrics in Grass Lake, Michigan and active in the NPI registry since June 2012. The organization holds a CLIA Waiver certificate valid through March 3, 2027 and lists Joel Dinverno, Owner, as its authorized official.

NPPES Registry Identity

NPI1053674184
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameJOEL DINVERNO MD PC
Location Address11755 E MICHIGAN AVEGrass Lake, MI 49240-9219
Mailing Address11755 E Michigan AveGrass Lake, MI 49240-9219 · (517) 522-6100 · Fax (517) 522-4715
Phone(517) 522-6100
Fax(517) 522-4715
Organization SubpartNo
Authorized OfficialJoel DinvernoOwner · (517) 522-6100
Enumeration DateJune 22, 2012
✔ NPI 1053674184 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in MI · 4301073676
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
11755 E MICHIGAN AVE, Grass Lake, MI 49240
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Other Names 1

Doing Business AsSacred Heart Pediatrics

Other Identifiers 3

Medicare UPING73511MI
Other3503810581MI · Bcbs
Medicaid104717265MI

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D1037775

Sacred Heart Pediatrics · Grass Lake, MI
Active · expires Mar 3, 2027
CLIA Number23D1037775
Laboratory TypePhysician Office
Certificate Effective DateMarch 4, 2025
Certificate Expiration DateMarch 3, 2027
Laboratory DirectorJoel B. Dinverno
Laboratory Phone(517) 522-6408
Laboratory LocationSacred Heart Pediatrics11755 E Michigan Avenue, Grass Lake, MI 49240
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. CHERYL KENNEDY-REUL PT
Physical Therapist
11755 E MICHIGAN AVE
GRASS LAKE, MI 49240
Jackson County (517) 234-3430
JOEL BENJAMIN DINVERNO MD
Pediatrics
11755 E MICHIGAN AVE
GRASS LAKE, MI 49240
Jackson County (517) 522-6100
REBECCA L BOWMAN PT
Physical Therapist
11755 E MICHIGAN AVE
GRASS LAKE, MI 49240
Jackson County (517) 234-3430
BE ACTIVE PHYSICAL THERAPY & WELLNESS, PLLC
Clinic/Center (Physical Therapy)
11755 E MICHIGAN AVE
GRASS LAKE, MI 49240
Jackson County (734) 644-1716

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Joel Dinverno MD PC's NPI number?

The NPI number for Joel Dinverno MD PC is 1053674184. It was assigned to this organization in the NPPES registry on June 22, 2012. The provider is doing business as Sacred Heart Pediatrics.

Where is Joel Dinverno MD PC located?

Joel Dinverno MD PC is located at 11755 E Michigan Ave, Grass Lake, MI 49240. The listed phone number is (517) 522-6100.

What is Joel Dinverno MD PC's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Joel Dinverno MD PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D1037775) is associated with this NPI, valid through March 3, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Joel Dinverno MD PC was last updated on June 22, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.