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Deactivated NPI 1669474193 Deactivated / Inactive NPI Male Practitioner

Dr. Peter Andrew Antonacopoulos , MD

Internal Medicine • Gladwin, MI

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Peter Antonacopoulos has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 15, 2005
NPI Deactivation Date November 04, 2019
Total Practice Duration ~14 Years of Practice (2005 – 2019)

Professional Overview & Biography Verified Profile Summary

Dr. Peter Antonacopoulos, MD was a registered Internal Medicine practicing in Gladwin, MI. Throughout an active medical career spanning 14 years, Dr. Antonacopoulos provided care at the practice location at 609 QUARTER ST until profile deactivation on 2019-11-04.

Historical Medicare Part B clinical services included exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician, exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

609 Quarter St

Gladwin, MI 486241941

Telephone 9892466420
Fax 9892466430
Associated Practice Facility / Clinic
🏢 Midmichigan Cardiology, Pc Facility NPI 1598954836

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Gladwin, MI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 34.0 Yrs
State Avg: 26.5 Yrs
Regional Practice Density
3 Specialists

Practicing in Gladwin, MI (6010 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
84.8% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2019)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
93016 Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician
29 28 $127.00 $22.23
93018 Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician
29 28 $116.00 $14.80

Medical Specialties & State Licenses

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License MI 4301046639

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

10 Associated Practitioners
Dr. Jeffrey Stone , DPM

Podiatrist - Foot & Ankle Surgery

NPI 1124177977

Doctor of Podiatric Medicine

NPI 1174548747

Doctor of Medicine (M.D.)

Beau Bailer

Physical Therapist - Orthopedic

NPI 1306330519
Chelsea Hutchinson

Physical Therapist

NPI 1346848140
Dr. Cheryl Loubert , MD

Internal Medicine

NPI 1376553586

Doctor of Medicine (M.D.)

Sara Sisco

Nurse Practitioner

NPI 1386068872

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated November 04, 2019

Record deactivated on November 04, 2019

NPI Profile Active March 13, 2012

NPI status registered as active in NPPES database

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Updated Practice Location March 13, 2012

Registered at 609 QUARTER ST, GLADWIN, MI 486241941 (Tel: 9892466420)

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Updated Business Mailing Address March 13, 2012

Registered at 609 QUARTER ST, GLADWIN, MI 486241941 (Tel: 9892466420)

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Provider Name / Credentials Updated March 13, 2012

Recorded as PETER ANTONACOPOULOS, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) March 13, 2012

Internal Medicine (License #4301046639 in MI)

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Initial NPI Registration & Enumeration August 15, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1669474193
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 15, 2005
Last Update: March 13, 2012
Deactivation Date: November 04, 2019

Mailing Address

609 Quarter St

Gladwin, MI 486241941

Phone: 9892466420

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.