STEPHEN CHARLES PETERSON (DO) – Family Medicine Physician, NPI 1114331535
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,418 FAMILY PRACTICE in MI
Provider Addresses for STEPHEN CHARLES PETERSON (DO)
100 MICHIGAN ST NE # MC845
GRAND RAPIDS, MI 495032560
Phone:
Type: Mailing
PO BOX 1848
MUSKEGON, MI 494431848
Phone: (231) 727-4444
Fax: (231) 727-4571
Type: Mailing
14755 215TH AVE
BIG RAPIDS, MI 493079224
Phone: (231) 796-3200
Type: Location
14 N 3RD AVE
FRUITPORT, MI 494158942
Phone: (231) 672-7140
Fax: (231) 672-7141
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2015-11-02
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20151102000231 | I | Family Practice | MI | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 82962 | Blood glucose (sugar) test performed by hand-held instrument | 34 | 19 | $0 |
| 83036 | Hemoglobin a1c level | 33 | 19 | $0 |
Insurance plans in this area (ZIP 49503)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | MI | |
| Physician Assistant | OR | |
| Physician Assistant | MI | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MI | |
| Physician Assistant | MI | |
| Physician Assistant | MI | |
| Family Practice | MI | |
| Physician Assistant | MI | |
| Physician Assistant | MI | |
| Nurse Practitioner | MI |
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