PETER C THEUT MD
NPI 1720076219
Orthopaedic Surgery - Sports Medicine in Grand Rapids, MI

Q: What is Peter Theut's NPI number?

The NPI number for Peter Theut is 1720076219. It was assigned to this individual provider in the NPPES registry on October 10, 2005.

Q: What is Peter Theut's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Sports Medicine, with taxonomy code 207XX0005X.

Q: When was this NPI record last updated?

The NPPES record for Peter Theut was last updated on March 12, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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 October 10, 2005PECOS EnrolledAccepts Medicare Assignment

1111 LEFFINGWELL AVE NE, STE 100, GRAND RAPIDS, MI 49525(616) 459-7101 Get Directions Write a Review

NPPES record last updated: March 12, 2013. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About Peter C Theut Md NPPES

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

PETER C THEUT MD (NPI 1720076219) is an individual sports medicine provider in Grand Rapids, Michigan, licensed in Michigan (4301063761) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS, is affiliated with Spectrum Health, and is a graduate of Michigan State University College Of Human Medicine (1994).

NPPES Registry Identity

NPI1720076219

Entity TypeIndividualMale

Primary Taxonomy207XX0005X

Provider Legal NamePETER C THEUTCredential: MD

Location Address1111 LEFFINGWELL AVE NE, STE 100Grand Rapids, MI 49525-6406

Mailing Address1111 Leffingwell Ave Ne, Ste 100Grand Rapids, MI 49525-6406 · (616) 459-7101

Phone(616) 459-7101

Sole ProprietorNo

Medical School CMSMichigan State University College Of Human MedicineGraduated 1994

Enumeration DateOctober 10, 2005

Last NPPES UpdateMarch 12, 2013

✔ NPI 1720076219 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic Surgery · Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207XX0005X

License✔ Licensed in MI · 4301063761

Definition

An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.

1111 LEFFINGWELL AVE NE, Grand Rapids, MI 49525

Open in Google Maps ↗

Other Identifiers 6

Medicare ID-Type Unspecified0D14869

Medicare PIN200041042

Medicare UPING52738

Medicaid4216995MI

Medicare NSC0442790001

Medicare PIN0D14869017

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Priority Health.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

Peter C Theut 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 ID2668417833

PECOS Enrollment IDI20100114000436

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 Reassignments

Medicare enrollment records show Peter Theut reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Orthopaedic Associates Of Grand Rapids, PC

Same address

Orthopaedic Surgery

1111 LEFFINGWELL AVE NE
Grand Rapids, MI 49525

Reassigned Medicare billing, Michigan enrollment
69 clinicians in this Medicare group

NPI 1023021300 (616) 459-7101

Metropolitan Hospital

2.8 mi

Urgent Care

4055 CASCADE RD SE
Grand Rapids, MI 49546

Reassigned Medicare billing, Michigan enrollment
685 clinicians in this Medicare group

NPI 1720590961 (616) 252-4010

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 9

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.

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.

71 services64 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.

66 services63 patients

X-ray of shoulder, minimum of 2 views 73030

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

62 services51 patients

Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg J0702

This injection contains two medications, betamethasone acetate and betamethasone sodium phosphate. It is used to reduce inflammation and pain. It's given by a healthcare professional, often directly into the area causing discomfort.

42 services20 patients

Prosthetic repair of shoulder joint, total shoulder 23472

Total shoulder prosthetic repair is a surgical procedure to replace a damaged shoulder joint with artificial components. It aims to relieve pain and restore mobility. The procedure involves replacing the ball (humeral head) and socket (glenoid) of the shoulder joint.

27 services27 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

22 services21 patients

Hospital Affiliations CMS Care Compare 2

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

Spectrum Health

Acute Care Hospitals · Grand Rapids, MI

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230038

Location100 Michigan St NEGrand Rapids, MI 49503 · Kent County

Emergency services Birthing friendly

University Of Michigan Health - West

Acute Care Hospitals · Wyoming, MI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230236

Location5900 Byron Center Avenue, SWWyoming, MI 49519 · Kent County

Emergency services Birthing friendly

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf L3670

DME-Orthotic Devices · category DF000N

2 suppliers27 claims27 services$73.88 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

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

JUSTIN MICHAEL MILLER PA

Physician Assistant (Surgical)

1111 LEFFINGWELL AVE NE
GRAND RAPIDS, MI 49525

Kent County (616) 459-7101

DR. CHARLES D BUKREY MD

Orthopaedic Surgery

1111 LEFFINGWELL AVE NE, SUITE 100
GRAND RAPIDS, MI 49525

Kent County (616) 459-7101

LAURA L BUCKS OT

Occupational Therapist

1111 LEFFINGWELL AVE NE, SUITE 200
GRAND RAPIDS, MI 49525

Kent County (616) 459-7101

KURT THOMAS GEFFKEN MD

Orthopaedic Surgery

1111 LEFFINGWELL AVE NE
GRAND RAPIDS, MI 49525

Kent County (616) 459-7101

ORTHOPAEDIC ASSOCIATES OF GRAND RAPIDS, PC

Orthopaedic Surgery

1111 LEFFINGWELL AVE NE
GRAND RAPIDS, MI 49525

Kent County (616) 459-7101

SCOTT DAVID BURGESS MD

Orthopaedic Surgery (Hand Surgery)

1111 LEFFINGWELL AVE NE, SUITE 200
GRAND RAPIDS, MI 49525

Kent County (616) 459-7101

KELLY J NYE OT

Occupational Therapist

1111 LEFFINGWELL AVE NE, SUITE 200
GRAND RAPIDS, MI 49525

Kent County (616) 459-7101

JOSEPH N PIGORSH PAC

Physician Assistant (Surgical)

1111 LEFFINGWELL AVE NE, STE 100
GRAND RAPIDS, MI 49525

Kent County (616) 459-7101

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 Peter Theut's NPI number?

The NPI number for Peter Theut is 1720076219. It was assigned to this individual provider in the NPPES registry on October 10, 2005.

Where is Peter Theut located?

Peter Theut practices at 1111 Leffingwell Ave NE Ste 100, Grand Rapids, MI 49525. The listed phone number is (616) 459-7101.

What is Peter Theut's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Sports Medicine, with taxonomy code 207XX0005X.

Is Peter Theut enrolled in Medicare?

Yes. Peter Theut is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Peter Theut's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Peter Theut reassigns Medicare benefits to 2 organizations: Orthopaedic Associates Of Grand Rapids, PC (Grand Rapids, MI) and Metropolitan Hospital (Grand Rapids, MI). Each 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 Peter Theut's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Peter Theut accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company and Priority Health list Peter Theut 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.

Is Peter Theut affiliated with any hospitals?

According to CMS data, Peter Theut is affiliated with Spectrum Health and University Of Michigan Health - West.

When was this NPI record last updated?

The NPPES record for Peter Theut was last updated on March 12, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.