DR. JEROD ROBERT GARDNER (DO) – Family Medicine Physician, NPI 1902465743
Family Medicine Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
4,418 FAMILY PRACTICE in MI
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Provider Addresses for DR. JEROD ROBERT GARDNER (DO)
2420, North Road, Fenton, Genesee County, Michigan, 48430, United States
FENTON, MI 484301891
Phone: (517) 927-8609
Type: Mailing
1460, North Center Road, Burton, Genesee County, Michigan, 48509, United States
BURTON, MI 485091429
Phone: (810) 715-4300
Type: Location
230 S MAPLE ST
GRANT, MI 493279006
Phone: (231) 834-5995
Type: Location
418 WASHINGTON ST
LAKEVIEW, MI 488507102
Phone: (989) 352-6474
Type: Location
100 MICHIGAN ST NE # MC845
GRAND RAPIDS, MI 495032560
Phone:
Type: Mailing
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 $19.
Total Amount is formed as General ($19) + Research ($0) + Ownership ($0) = $19.
Last reported payment date: 2024-02-29 • Largest payer in this snapshot: Novo Nordisk Inc ($19).
Total Amount
$19
General + Research + Ownership
Payments
1
Total payment records
General Amount
$19
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-02-29
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Novo Nordisk Inc | $19 |
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: 2022-06-23
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 |
|---|---|---|---|---|
| I20220623000766 | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 48430)
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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 |
Reviews
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