MICHAEL DOMINIC PEZZILLO MD - NPI 1952890519 - Obstetrics & Gynecology in Kalamazoo, MI

Q: What is Michael Pezzillo's NPI number?

The NPI number for Michael Pezzillo is 1952890519. It was assigned to this individual provider in the NPPES registry on May 8, 2018.

Q: What is Michael Pezzillo's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Q: When was this NPI record last updated?

The NPPES record for Michael Pezzillo was last updated on October 1, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Michael Dominic Pezzillo Md NPPES

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

MICHAEL DOMINIC PEZZILLO MD (NPI 1952890519) is an individual obstetrics & gynecology provider in Kalamazoo, Michigan, licensed in Michigan (4351050377) and active in the NPI registry since May 2018. He is enrolled in Medicare PECOS, maintains 3 additional practice locations, and is a graduate of Wayne State University School Of Medicine (2018).

NPPES Registry Identity

NPI1952890519

Entity TypeIndividualMale

Primary Taxonomy207V00000X

Provider Legal NameMICHAEL DOMINIC PEZZILLOCredential: MD

Location Address601 JOHN ST STE N1200Kalamazoo, MI 49007-5318

Mailing Address601 John St # 42Kalamazoo, MI 49007-5341

Phone(269) 341-7979

Sole ProprietorNo

Medical School CMSWayne State University School Of MedicineGraduated 2018

Enumeration DateMay 8, 2018

Last NPPES UpdateOctober 1, 2025

NPPES CertifiedOctober 1, 2025

✔ NPI 1952890519 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians

Taxonomy Code207V00000X

License✔ Licensed in MI · 4351050377

Definition

An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

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

601 JOHN ST STE N1200, Kalamazoo, MI 49007

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Secondary Practice Locations 3

Location 13031 W Grand BlvdDetroit, MI 48202-3046 · Phone (313) 916-1023 · Fax (313) 916-9713

Location 2920 Madison Ave Suite 447Memphis, TN 38163-2807 · Phone (901) 448-4795

Location 3853 Jefferson Ave Rm E102Memphis, TN 38103-2807 · Phone (901) 448-4795 · Fax (901) 448-7075

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Michael Dominic Pezzillo Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1153828777

PECOS Enrollment IDI20251009001366

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49007 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

$126.15 typical visit price

range $54.34 – $166.68

Typical copayment $31.53 (range $13.58 – $41.67)

Most-billed visit code 99204

Established Patient

$68.07 typical visit price

range $17.09 – $135.40

Typical copayment $17.01 (range $4.27 – $33.85)

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 12

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

MRS. GABRAELLE ELIZABETH FOUNE FNP-C

Nurse Practitioner (Family)