DR. EDWIN ROBERT ITENBERG (D.O.) – Colon & Rectal Surgery Physician, NPI 1255508487
Colon & Rectal Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,444 GENERAL SURGERY in MI
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Provider Addresses for DR. EDWIN ROBERT ITENBERG (D.O.)
Ascension Providence Hospital, Southfield Campus, 16001, West 9 Mile Road, Southfield, Oakland County, Michigan, 48075, United States
FISHER BUILDING 3RD FLOOR
SOUTHFIELD, MI 480754818
Phone: (248) 849-6030
Fax: (248) 849-6039
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 17 Open Payments records for all available years, with a total value of $10,105.
Total Amount is formed as General ($10,105) + Research ($0) + Ownership ($0) = $10,105.
Last reported payment date: 2024-10-30 • Largest payer in this snapshot: Intuitive Surgical, Inc. ($9,956).
Total Amount
$10,105
General + Research + Ownership
Payments
17
Total payment records
General Amount
$10,105
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-30
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Intuitive Surgical, Inc. | $9,956 |
| Abbott Laboratories | $97 |
| CONMED Corporation | $51 |
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: 2013-01-21
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 |
|---|---|---|---|---|
| I20130121000170 | I | Colorectal Surgery (Proctology) | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 36 | 29 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 15 | 15 | $0 |
| 46600 | Diagnostic exam of anus using an endoscope | 14 | 14 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 14 | 11 | $0 |
| 45385 | Removal of polyps or growths of large bowel using an endoscope with mechanical snare | 11 | 11 | $0 |
Insurance plans in this area (ZIP 48075)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| COLORECTAL SURGERY (PROCTOLOGY) | MI | 45385 | Removal of polyps or growths of large bowel using an endoscope | 13 | 12 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MI | |
| Gastroenterology, Internal Medicine | PA | |
| Certified Registered Nurse Anesthetist (Crna) | MI | |
| Clinical Social Worker | MI | |
| - | MI | |
| Physician Assistant | MI | |
| Qualified Audiologist | MI | |
| O P H T H A L M O L O G Y | MI | |
| - | MI | |
| - | MI |
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