Individual provider Active NPI

Mary Koshey Morreale, MD

  • Psychiatry Physician
  • Detroit, MI
National Provider Identifier
1174563654
Registry record updated Sep 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
4301083591 Issued in MI
Practice address
Sinai Grace Hospital
6071 W Outer Dr
Detroit, MI 48235
Phone
(313) 493-6800
NPI assigned
Jun 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 4301083591 MI Primary

Addresses

Primary practice location

Sinai Grace Hospital
6071 W Outer Dr
Detroit, MI 48235

Mailing address

1560 E Maple Rd
Suite 400-Credentialing
Troy, MI 48083-1138
Phone (248) 581-5971

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
I20050124000758 MI Practitioner - Psychiatry 5395795785 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Wayne State University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Physician GroupGroup PAC ID 8628087681, 399 clinicians

Practice addresses (Care Compare)

1560 E Maple Rd
Troy, MI 48083-1135
Phone (248) 581-5200

31995 Northwestern Hwy
Farmington Hills, MI 48334-1625
Phone (800) 527-6266

3901 Chrysler Dr
Detroit, MI 48201-2167

4100 John R St
Detroit, MI 48201-2013
Phone (800) 527-6266

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Group CurrentSince Oct 1, 2006 Accepting new patients
University Physician Group Psychiatry Past Accepting new patients

Locations

4100 John R St
Detroit, MI 48201
Phone (313) 576-8530

6071 W Outer Dr
Detroit, MI 48235
Phone (313) 966-3300

3901 Chrysler Dr
#P
Detroit, MI 48201
Phone (313) 993-3434

1560 E Maple Rd
Ste 400
Troy, MI 48083

1560 E Maple Rd
Ste 200
Troy, MI 48083
Phone (248) 581-5200

Interoperability endpoints

  • Direct secure messaging: mary.morreale.1@19711.direct.athenahealth.com

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.

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474588800000",
    "number": "1174563654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 E MAPLE RD",
            "address_2": "SUITE 400-CREDENTIALING",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831138",
            "telephone_number": "248-581-5971",
            "fax_number": "248-581-5640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SINAI GRACE HOSPITAL",
            "address_2": "6071 W OUTER DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48235",
            "telephone_number": "313-493-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORREALE",
        "first_name": "MARY",
        "middle_name": "KOSHEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2016-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301083591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.