Individual provider Active NPI

Priyanka Patil, MD

  • Child & Adolescent Psychiatry Physician
  • Clarkston, MI
National Provider Identifier
1053796045
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
297956-01 Issued in NY
Practice address
8031 Ortonville Rd Ste 190
Clarkston, MI 48348-4484
Phone
(248) 997-7848
NPI assigned
Jul 20, 2015
Last updated
Jun 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 297956-01 NY Primary

Addresses

Primary practice location

8031 Ortonville Rd Ste 190
Clarkston, MI 48348-4484

Mailing address

4055 Nottingham Cir
Clarkston, MI 48346-1760

Other names 1

  • Priyanka Anilkumar Patil Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200911000575 NY Practitioner - Psychiatry 0143566935 Reassigns benefits to 2 organizations
I20251103003331 MI Practitioner - Psychiatry 0143566935 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tuscola County Community Mental Health Services BoardGroup PAC ID 0941193619, 11 clinicians
County of LapeerGroup PAC ID 4183533193, 23 clinicians

Practice addresses (Care Compare)

1332 Prospect Ave
Caro, MI 48723-9288
Phone (989) 673-6191

1570 Suncrest Dr
Lapeer, MI 48446-1154
Phone (810) 667-0500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
297956-01NYMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Lapeer CurrentSince Sep 23, 2025 Accepting new patients
Tuscola County Community Mental Health Services Board CurrentSince Dec 8, 2025 Accepting new patients
Arise Child and Family Service Inc CurrentSince Mar 1, 2022 Accepting new patients
County of Lapeer CurrentSince Sep 23, 2025 Accepting new patients
Psychiatry Faculty Practice, Inc. CurrentSince Sep 16, 2020 Accepting new patients
Thinkhealth Integrative Psychiatry PC CurrentSince Jun 15, 2025 Accepting new patients

Locations

1332 Prospect Ave
Caro, MI 48723
Phone (989) 673-6191

323 N State St
Caro, MI 48723
Phone (989) 673-6191

8031 Ortonville Rd
Ste 190
Clarkston, MI 48348
Phone (248) 457-5113

1570 Suncrest Dr
Lapeer, MI 48446
Phone (810) 667-0244

635 James St
Syracuse, NY 13203
Phone (315) 472-3171

713 Harrison St
Bldg 3
Syracuse, NY 13210
Phone (315) 464-3265

719 Harrison St
Syracuse, NY 13210
Phone (315) 464-3265

750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1437350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1053796045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4055 NOTTINGHAM CIR",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483461760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8031 ORTONVILLE RD STE 190",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483484484",
            "telephone_number": "248-997-7848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATIL",
        "first_name": "PRIYANKA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-20",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NY",
            "license": "297956-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PRIYANKA",
            "last_name": "PATIL",
            "middle_name": "ANILKUMAR",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Clarkston, MI

Sources for this page

Verify at the official NPI Registry.