DR. JACK TREBELHORN MD
NPI 1619331998
Urology in Saint Clair Shores, MI

Q: What is Jack Trebelhorn's NPI number?

The NPI number for Jack Trebelhorn is 1619331998. It was assigned to this individual provider in the NPPES registry on April 12, 2016.

Q: What is Jack Trebelhorn's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Q: When was this NPI record last updated?

The NPPES record for Jack Trebelhorn was last updated on June 9, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since April 12, 2016PECOS EnrolledAccepts Medicare Assignment

20952 E 12 MILE RD STE 200, SAINT CLAIR SHORES, MI 48081(586) 771-4820(303) 485-3377 Get Directions Write a Review

NPPES record last updated: June 9, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 9, 2022, Jan 12, 2022, Nov 9, 2021 (3 updates tracked since 2021).

On this page

About Dr. Jack Trebelhorn Md NPPES

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

DR. JACK TREBELHORN MD (NPI 1619331998) is an individual urology provider in Saint Clair Shores, Michigan, licensed in Colorado (DR.0067578) and active in the NPI registry since April 2016. He is enrolled in Medicare PECOS, is affiliated with Henry Ford Macomb Hospital, and is a graduate of Medical College Of Wisconsin (2016).

NPPES Registry Identity

NPI1619331998

Entity TypeIndividualMale

Primary Taxonomy208800000X

Provider Legal NameDR. JACK TREBELHORNCredential: MD

Location Address20952 E 12 MILE RD STE 200Saint Clair Shores, MI 48081-3203

Mailing Address20952 E 12 Mile Rd Ste 200Saint Clair Shores, MI 48081-3203 · (586) 771-4820 · Fax (303) 485-3377

Phone(586) 771-4820

Fax(303) 485-3377

Sole ProprietorNo

Medical School CMSMedical College Of WisconsinGraduated 2016

Enumeration DateApril 12, 2016

Last NPPES UpdateJune 9, 20223 updates tracked since enumeration

NPPES CertifiedJune 9, 2022

✔ NPI 1619331998 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians

Taxonomy Code208800000X

License✔ Licensed in CO · DR.0067578

Definition

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

20952 E 12 MILE RD STE 200, Saint Clair Shores, MI 48081

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Other Identifiers 1

Medicaid1619331998MI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Jack Trebelhorn Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6800180050

PECOS Enrollment IDI20220610002496

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jack Trebelhorn reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Alliance Physician Services Of Michigan, P.C.

Same address

Urology

20952 12 MILE RD, SUITE 200
St Clair Shores, MI 48081

Reassigned Medicare billing, Michigan enrollment
Medicare enrollment name: Michigan Institute Of Urology PC
86 clinicians in this Medicare group

NPI 1427027416 (586) 771-4820

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

Areas of Expertise CMS Part B claims 25

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

463 services287 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

384 services251 patients

Ultrasound measurement of bladder capacity after voiding 51798

Ultrasound measurement of bladder capacity after voiding is a non-invasive test that uses sound waves to create images of your bladder. It's done after you've emptied your bladder to see if there's any leftover urine, which can help diagnose certain conditions.

199 services147 patients

Psa (prostate specific antigen) measurement, total 84153

PSA measurement is a simple blood test that checks for a specific protein produced by your body. High levels could indicate a health issue that needs further investigation. It's often used to monitor general wellness and is part of routine health screening.

95 services77 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

77 services68 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

76 services61 patients

Complete ultrasound scan behind abdominal cavity 76770

A complete ultrasound scan behind the abdominal cavity is a non-invasive imaging procedure. It uses sound waves to create pictures of the structures and organs located at the back of your abdomen. It helps in diagnosing health conditions and monitoring ongoing treatments.

71 services35 patients

Diagnostic exam of bladder and urethra using an endoscope 52000

This procedure involves using a thin, flexible tube with a light, called an endoscope, to examine the bladder and urethra. It helps in identifying any abnormalities or issues that may be causing discomfort or other symptoms.

68 services60 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

61 services61 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

61 services14 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

52 services49 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

43 services31 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

31 services14 patients

Biopsy of prostate gland 55700

A biopsy of the prostate gland is a procedure where a small sample of tissue is taken from your body's internal gland, located near the bladder, for testing. This helps in diagnosing potential health issues. It's usually done with a fine needle and imaging technology for accuracy.

28 services28 patients

Blood test, basic group of blood chemicals (calcium, total) 80048

A basic group blood test measures the levels of certain chemicals in your blood, including calcium. This helps assess your overall health and detect potential problems. The procedure involves drawing a small amount of blood from your arm, which is then analyzed in a lab.

26 services20 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

24 services24 patients

Complex measurement of pressure of urine flow in bladder with voiding pressure studies 51728

This procedure measures the pressure in your bladder as it fills and empties. It helps to understand how well your bladder is functioning. Sensors record pressure levels during these processes, providing valuable data for your doctor.

20 services20 patients

Simple bladder irrigation and/or instillation 51700

Bladder irrigation and/or instillation is a process where a sterile solution is introduced into the bladder to cleanse it or deliver medication. This procedure helps manage certain bladder conditions, ensuring optimal bladder health.

19 services17 patients

Non-needle measurement and recording of electrical activity of muscles at bladder and bowel openings 51784

This procedure involves the use of non-invasive devices to record the electrical activity of muscles at specific body openings. It's helpful in understanding muscle function and can assist in diagnosing certain conditions.

19 services19 patients

Testosterone (hormone) level, total 84403

A total testosterone level test measures the amount of a key hormone in your body. This hormone influences various body functions such as muscle mass, energy levels, and mood. The test involves a simple blood draw, and results help monitor health conditions.

17 services13 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

16 services11 patients

Imaging of urinary tract following injection of a contrast agent 74420

This procedure involves injecting a contrast agent into your body to help highlight the urinary tract during imaging. The contrast agent makes your urinary tract more visible on the images, providing detailed information about its structure and function. This can help in diagnosing any potential issues.

15 services14 patients

Ultrasound scan of pelvic region through rectum 76872

An ultrasound scan of the pelvic region through the rectum is a medical procedure where a small, smooth device is gently inserted into the rectum. This device uses sound waves to create images of the internal structures in the lower abdomen, aiding in diagnosis and treatment planning.

15 services15 patients

Telephone medical discussion with physician, 11-20 minutes 99442

This is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.

13 services13 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

12 services12 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Henry Ford Macomb Hospital

Acute Care Hospitals · Clinton Township, MI

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230047

Location15855 Nineteen Mile RdClinton Township, MI 48038 · Macomb County

Emergency services Birthing friendly

Beaumont Hospital - Grosse Pointe

Acute Care Hospitals · Grosse Pointe, MI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230089

Location468 Cadieux RdGrosse Pointe, MI 48230 · Wayne County

Emergency services Birthing friendly

Beaumont Hospital Royal Oak

Acute Care Hospitals · Royal Oak, MI

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230130

Location3601 W Thirteen Mile RdRoyal Oak, MI 48073 · Oakland County

Emergency services Birthing friendly

Ascension St John Hospital

Acute Care Hospitals · Detroit, MI

2/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number230165

Location22101 Moross RdDetroit, MI 48236 · Wayne County

Emergency services Birthing friendly

Beaumont Hospital, Troy

Acute Care Hospitals · Troy, MI

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230269

Location44201 Dequindre RoadTroy, MI 48085 · Oakland County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48081 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$134.28 typical visit price

range $58.04 – $177.36

Typical copayment $33.57 (range $14.51 – $44.34)

Most-billed visit code 99204

Established Patient

$72.38 typical visit price

range $18.32 – $143.49

Typical copayment $18.09 (range $4.58 – $35.87)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 8

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

CARRIE L ANDERSON

Nurse Practitioner (Family)