DENNIS PELON PHD, PC — NPI 1265532576 (Licensed & Credentialed Clinical Neuropsychologist in HASLETT, MI)

CMS-1500 Box 24J / 33a • NPI

1265532576

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

103G00000X

Licensed & Credentialed Clinical Neuropsychologist

Box 32 Service Location & ZIP+4

1640 HASLETT RD, SUITE 110, HASLETT, MI, 48840-8691

✓ 9-Digit EDI 837 ZIP+4 (48840-8691)

Practice Phone & Referral Fax

(517) 339-1686

Fax: (517) 339-3286

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1265532576 (DENNIS PELON PHD, PC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1265532576` (NPI-2 Organization / Facility)
Provider / Legal Name	DENNIS PELON PHD, PC
Plain-English Specialty	Licensed & Credentialed Clinical Neuropsychologist NUCC Code: `103G00000X` (Clinical Neuropsychologist)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	1640 HASLETT RD, SUITE 110, HASLETT, MI, 48840-8691
Practice Telephone / Fax	Tel: (517) 339-1686 \| Fax: (517) 339-3286
Administrative Mailing Address	1640 HASLETT RD, HASLETT, MI, 48840-8691
Enumeration & Last Sync	Enumerated: 2006-09-25 \| CMS Record Updated: 2020-08-22
Authorized Official	DENNIS PELON (Owner)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

1640 HASLETT RD, SUITE 110, HASLETT, MI, 48840-8691

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Plain-English Taxonomy & CMS Crosswalk (103G00000X)

What Does Taxonomy Code 103G00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 103G00000X translates to:
"Licensed & Credentialed Clinical Neuropsychologist"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Clinical Neuropsychologist for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (DENNIS PELON PHD, PC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`103G00000X` — Clinical Neuropsychologist Plain English: Licensed & Credentialed Clinical Neuropsychologist	State: MI \| License: `6301002693` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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DENNIS PELON PHD, PC (NPI #1265532576)