DR. MICHAEL DOUGLAS PEACOCK (MD) – Emergency Medicine Physician, NPI 1104145200

DR. MICHAEL DOUGLAS PEACOCK (MD) is a healthcare provider. based in Ann arbor, Michigan. specializing in EMERGENCY MEDICINE. They hold the professional credentials MD. They hold a License No. 4301096679 (MI). The NPI Number for DR. MICHAEL DOUGLAS PEACOCK (MD) is 1104145200

Main info

Male
16 Years Of Experience
Accepts Medicare Assignment
Name
DR. MICHAEL DOUGLAS PEACOCK (MD)
NPI
1104145200
Phone
(734) 763-7919
Address
1500 E. MEDICAL CENTER DRIVE
Enumeration Date
28 May 2010
Last Update Date
22 August 2013

Doctor Profile

Medical School Name
MICHIGAN STATE UNIVERSITY COLLEGE OF HUMAN MEDICINE
Secondary Phone
2318767200
Graduation Year
2010 (16 years ago)
PAC ID
6406005594
Group Practice PAC ID
4082069232
Professional Enrollment ID
I20130917000267
Address ID
MI496012331CA400XXSTXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience51
Completeness75
Years active:16State licenses:1Digital endpointsOther names

3,157 EMERGENCY MEDICINE in MI

Provider Addresses for DR. MICHAEL DOUGLAS PEACOCK (MD)

  • 1500 E. MEDICAL CENTER DRIVE

    B1-380 TC

    ANN ARBOR, MI 481095305

    Phone: (734) 763-7919

    Fax: (734) 763-9298

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $20.

Total Amount is formed as General ($20) + Research ($0) + Ownership ($0) = $20.

Last reported payment date: 2023-12-04 • Largest payer in this snapshot: CSL Behring ($20).

Total Amount

$20

General + Research + Ownership

Payments

1

Total payment records

General Amount

$20

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-12-04

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
CSL Behring$20
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2013-09-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20130917000267IEmergency MedicineMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99285Emergency department visit with high level of medical decision making130123$0
99284Emergency department visit with moderate level of medical decision making120115$0
93010Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only9379$0
99291Critical care, first 30-74 minutes5656$0
99283Emergency department visit with low level of medical decision making1717$0
View full utilization report →

Insurance plans in this area (ZIP 48109)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4082069232View full group profile
NameSpecialtyState
Emergency MedicineMI
Emergency MedicineMI
Emergency MedicineMI
Nurse PractitionerMI
Emergency MedicineMI
Emergency MedicineMI
Nurse PractitionerMI
Emergency MedicineMI
Emergency MedicineMI
Emergency MedicineMI

Reviews

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Frequently asked questions

Can I cross-check DR. MICHAEL DOUGLAS PEACOCK (MD) using NPI 1104145200?
NPI 1104145200 belongs to DR. MICHAEL DOUGLAS PEACOCK (MD); compare other details if you need extra assurance.
Is DR. MICHAEL DOUGLAS PEACOCK (MD) still an active registrant?
DR. MICHAEL DOUGLAS PEACOCK (MD) carries an active NPI according to the public dataset.
How would a patient describe DR. MICHAEL DOUGLAS PEACOCK (MD)'s focus?
For DR. MICHAEL DOUGLAS PEACOCK (MD), the primary taxonomy reads as Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for DR. MICHAEL DOUGLAS PEACOCK (MD)?
Travel planning: use Ann Arbor, Michigan as the reference point for DR. MICHAEL DOUGLAS PEACOCK (MD), then confirm.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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