MR. EUGENE JR. PERNELL (PHD) – Psychologist, NPI 1386764694

MR. EUGENE JR. PERNELL (PHD) is a healthcare provider. based in East lansing, Michigan. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PHD. They hold a License No. 6301005277 (MI). The NPI Number for MR. EUGENE JR. PERNELL (PHD) is 1386764694

Main info

Male
55 Years Of Experience
Accepts Medicare Assignment
Name
MR. EUGENE JR. PERNELL (PHD)
NPI
1386764694
Phone
(517) 332-0811
Address
5031 PARK LAKE ROAD
Enumeration Date
30 March 2007
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5173320811
Graduation Year
1971 (55 years ago)
PAC ID
6901961093
Group Practice PAC ID
5193880284
Professional Enrollment ID
I20100121000009
Address ID
MI488233835EA5031XRDXX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,216 CLINICAL PSYCHOLOGIST in MI

Provider Addresses for MR. EUGENE JR. PERNELL (PHD)

  • 5031 PARK LAKE ROAD

    MERIDIAN PROFESSIONAL PSYCHOLOGICAL CONSULTANTS

    EAST LANSING, MI 488233835

    Phone: (517) 332-0811

    Fax: (517) 332-4452

    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)

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: 2010-01-21

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100121000009IClinical PsychologistMITBD

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
90837Psychotherapy, 1 hour13716$0
View full utilization report →

Insurance plans in this area (ZIP 48823)

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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: 5193880284View full group profile
NameSpecialtyState
Clinical Social WorkerMI
Clinical Social WorkerMI
Nurse PractitionerMI
Clinical Social WorkerMI
Clinical Social WorkerMI
Nurse PractitionerMI
Clinical Social WorkerMI
Clinical Social WorkerMI
Clinical Social WorkerMO
Mental Health CounselorMI

Reviews

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Frequently asked questions

Can I verify MR. EUGENE JR. PERNELL (PHD) with an NPI only?
You can start verification with NPI 1386764694 for MR. EUGENE JR. PERNELL (PHD), then check state licensing separately.
Does CMS list MR. EUGENE JR. PERNELL (PHD) as active?
Yes — MR. EUGENE JR. PERNELL (PHD) is active in the NPI listing used on this page.
What healthcare role does MR. EUGENE JR. PERNELL (PHD) hold?
Scheduling teams often label MR. EUGENE JR. PERNELL (PHD) under Psychologist. Clinical services aligned with this taxonomy classification.
Does MR. EUGENE JR. PERNELL (PHD) list a practice location?
Patients near East Lansing, Michigan may find MR. EUGENE JR. PERNELL (PHD) in results; validate coverage separately.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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