PETER C THEUT (MD) – Sports Medicine (Orthopaedic Surgery) Physician, NPI 1720076219
Sports Medicine (Orthopaedic Surgery) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
244 SPORTS MEDICINE in MI
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Provider Addresses for PETER C THEUT (MD)
1111, Leffingwell Avenue Northeast, Grand Rapids, Kent County, Michigan, 49525, United States
STE 100
GRAND RAPIDS, MI 495256406
Phone: (616) 459-7101
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 5 Open Payments records for all available years, with a total value of $226.
Total Amount is formed as General ($226) + Research ($0) + Ownership ($0) = $226.
Last reported payment date: 2024-03-11 • Largest payer in this snapshot: Medwest Associates ($145).
Total Amount
$226
General + Research + Ownership
Payments
5
Total payment records
General Amount
$226
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-03-11
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Medwest Associates | $145 |
| DePuy Synthes Sales Inc. | $42 |
| Baxter Healthcare | $24 |
| Zimmer Biomet Holdings, Inc. | $14 |
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: 2010-01-14
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 |
|---|---|---|---|---|
| I20100114000436 | I | Sports Medicine | 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 | 87 | 68 | $0 |
| 73030 | X-ray of shoulder, minimum of 2 views | 70 | 56 | $0 |
| J0702 | Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg | 55 | 23 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 46 | 42 | $0 |
| 20610 | Aspiration and/or injection of fluid from large joint | 30 | 24 | $0 |
Insurance plans in this area (ZIP 49525)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | MI | |
| Sports Medicine | MI | |
| Sports Medicine, Family Practice | MI | |
| Physician Assistant | MI | |
| Physician Assistant | IL | |
| Nurse Practitioner | MI | |
| N E U R O S U R G E R Y | IL | |
| Physician Assistant | MI | |
| Internal Medicine | MI | |
| Physician Assistant | MI |
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