Organization Active NPI

Agnes Wrobel Psychiatry PLLC

  • Addiction Psychiatry Physician
  • Sterling Heights, MI
National Provider Identifier
1093373763
Registry record updated May 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Psychiatry PhysicianTaxonomy code 2084P0802X
Legal business name
AGNES WROBEL PSYCHIATRY PLLC
Practice address
41400 Dequindre Rd Ste 121
Sterling Heights, MI 48314-3751
Phone
(586) 843-3815
NPI assigned
May 29, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2019

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

Authorized official

Name
Mrs. Dawn Marie Suttle
Title
Medical Billing Manager
Phone
(248) 673-1441

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0802X Primary

Addresses

Primary practice location

41400 Dequindre Rd Ste 121
Sterling Heights, MI 48314-3751

Mailing address

5036 Dixie Hwy # 261
Waterford, MI 48330-0016
Phone (248) 673-1441

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190711001489 MI Part B Supplier - Clinic/Group Practice 3779818851 Receives reassigned benefits from 2 practitioners
Practice locations: Sterling Heights, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1559088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559088000000",
    "number": "1093373763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5036 DIXIE HWY # 261",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483300016",
            "telephone_number": "248-673-1441",
            "fax_number": "888-599-0120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41400 DEQUINDRE RD STE 121",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483143751",
            "telephone_number": "586-843-3815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGNES WROBEL PSYCHIATRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-29",
        "last_updated": "2019-05-29",
        "status": "A",
        "authorized_official_last_name": "SUTTLE",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "MEDICAL BILLING MANAGER",
        "authorized_official_telephone_number": "248-673-1441",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2084P0802X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.