Dominic Ernest Misiak, DO

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

5101026126 Issued in MI

Practice address

44725 Grand River Ave Ste 104
Novi, MI 48375-1024

Phone

(517) 882-3732

NPI assigned

Mar 23, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Psychiatry

Education

Michigan State University College of Osteopathic Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Downriver Mental Health Clinic PCGroup PAC ID 7911995139, 289 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealth.dominicmisiak@150339.advancedmd-direct.com

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.

• Downriver Mental Health Clinic PC

  dba Lifestance Health, Inc

  • Psychologist
  • Taylor, MI
  • NPI 1295866135
  Medicare reassignment Care Compare group NPD
• Chelsea Community Hospital

  dba St. Joseph Mercy Chelsea

  • Psychiatry Physician
  • Chelsea, MI
  • NPI 1912947409
  Medicare reassignment NPD
• Chelsea Community Hospital

  • Urgent Care Clinic/Center
  • Chelsea, MI
  • NPI 1033778733
  NPD
• Downriver Mental Health Clinic PC

  dba Advanced Counseling Services PC

  • Psychologist
  • Taylor, MI
  • NPI 1104930130
  NPD

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

{
    "created_epoch": "1553299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1164982328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44725 GRAND RIVER AVE STE 104",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751024",
            "telephone_number": "517-882-3732",
            "fax_number": "517-882-3633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44725 GRAND RIVER AVE STE 104",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751024",
            "telephone_number": "517-882-3732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISIAK",
        "first_name": "DOMINIC",
        "middle_name": "ERNEST",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-23",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "5101026126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Miranda Ramirez
• Emaleigh Miranda
• Raquel Mireles
• Amber Mirza
• Karen Elizabeth Miscisin
• Ashley Missig
• Ashley Lorine Missinne
• Kathleen Mistretta, B.A.
• Samantha Mitchell-Ferrer
• Regina Lenore Mitchell-McWhorter

• Psychiatry Physician in Novi, MI
• Providers in Novi, MI by specialty
• Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.