PENINSULA PLASTIC AND RECONSTRUCTIVE SURGERY OF MICHIGAN
NPI 1316774110
Plastic Surgery in Novi, MI

Active since September 16, 2024
47601 GRAND RIVER AVE STE B233, NOVI, MI 48374(248) 465-5499 Get Directions Write a Review

NPPES record last updated: January 21, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Peninsula Plastic And Reconstructive Surgery Of Michigan NPPES

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

PENINSULA PLASTIC AND RECONSTRUCTIVE SURGERY OF MICHIGAN (NPI 1316774110) is a healthcare organization registered as a plastic surgery in Novi, Michigan and active in the NPI registry since September 2024. The organization lists Rachel Perry, Cred Coord, as its authorized official.

NPPES Registry Identity

NPI1316774110
Entity TypeOrganization
Primary Taxonomy208200000X
Legal Business NamePENINSULA PLASTIC AND RECONSTRUCTIVE SURGERY OF MICHIGAN
Location Address47601 GRAND RIVER AVE STE B233Novi, MI 48374-1204
Mailing Address47601 Grand River Ave Ste B233Novi, MI 48374-1204 · (248) 465-5499
Organization SubpartNo
Authorized OfficialRachel PerryCred Coord · (586) 209-8307
Enumeration DateSeptember 16, 2024
Last NPPES UpdateJanuary 21, 2025
NPPES CertifiedJanuary 21, 2025
✔ NPI 1316774110 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPlastic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208200000X
Definition
A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.
47601 GRAND RIVER AVE STE B233, Novi, MI 48374

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

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Peninsula Plastic And Reconstructive Surgery Of Michigan is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Peninsula Plastic And Reconstructive Surgery Of Michigan, which bills Medicare for the services this clinician delivers.

Clinician (1)

Plastic and Reconstructive Surgery
NPI 1295946200
47601 GRAND RIVER AVE SUITE B129
Novi, MI 48374
(248) 305-8400
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Peninsula Plastic And Reconstructive Surgery Of Michigan's NPI number?

The NPI number for Peninsula Plastic And Reconstructive Surgery Of Michigan is 1316774110. It was assigned to this organization in the NPPES registry on September 16, 2024.

Where is Peninsula Plastic And Reconstructive Surgery Of Michigan located?

Peninsula Plastic And Reconstructive Surgery Of Michigan is located at 47601 Grand River Ave Ste B233, Novi, MI 48374. The listed phone number is (248) 465-5499.

What is Peninsula Plastic And Reconstructive Surgery Of Michigan's specialty?

The primary specialty registered for this NPI is Plastic Surgery with taxonomy code 208200000X.

Is Peninsula Plastic And Reconstructive Surgery Of Michigan enrolled in Medicare?

Yes. Peninsula Plastic And Reconstructive Surgery Of Michigan is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Peninsula Plastic And Reconstructive Surgery Of Michigan?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Plastic and Reconstructive Surgery) reassigns their Medicare billing to Peninsula Plastic And Reconstructive Surgery Of Michigan. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Peninsula Plastic And Reconstructive Surgery Of Michigan accept?

Health plans from Blue Care Network of Michigan list Peninsula Plastic And Reconstructive Surgery Of Michigan as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Peninsula Plastic And Reconstructive Surgery Of Michigan was last updated on January 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months 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.