Individual provider Active NPI

Drew Alan Trentacosta, DO

  • Psychiatry Physician
  • Westland, MI
National Provider Identifier
1134624950
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
5101025632 Issued in MI
Practice address
30901 Palmer Rd
Westland, MI 48186-9529
Phone
(734) 367-8400
Fax
(734) 722-5562
NPI assigned
Mar 25, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 5101025632 MI Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

30901 Palmer Rd
Westland, MI 48186-9529

Mailing address

30901 Palmer Rd
Westland, MI 48186-9529
Phone (734) 367-8400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20220824000737 MI Practitioner - Psychiatry 4587910625 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of Michigan Office of Financial ManagementGroup PAC ID 5496650723, 22 clinicians

Practice addresses (Care Compare)

30901 Palmer Rd
Westland, MI 48186-9529
Phone (734) 367-8400

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
State of Michigan Office of Financial Management CurrentSince Jul 25, 2022 Accepting new patients
State of Michigan Office of Financial Management CurrentSince Jul 25, 2022 Accepting new patients

Locations

30901 Palmer Rd
Westland, MI 48186
Phone (734) 367-8400

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1521936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1134624950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30901 PALMER RD",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481869529",
            "telephone_number": "734-367-8400",
            "fax_number": "734-722-5562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30901 PALMER RD",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481869529",
            "telephone_number": "734-367-8400",
            "fax_number": "734-722-5562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRENTACOSTA",
        "first_name": "DREW",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-25",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "5101025632",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westland, MI

Sources for this page

Verify at the official NPI Registry.