Michael Andrew Bambery, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301010839 Issued in MI

Practice address

44450 Pinetree Dr
Suite 101
Plymouth, MI 48170-3869

Phone

(734) 738-0897

NPI assigned

Aug 9, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Arbor Psychology Group, PLLC

  • Clinical Psychologist
  • Plymouth, MI
  • NPI 1952789877
  Medicare reassignment NPD Authorized official
• Arbor Psychology Group of Northville, PLLC

  • Clinical Psychologist
  • Northville, MI
  • NPI 1659898526
  NPD Authorized official
• Arbor Psychology Group of Royal Oak, PLLC

  • Clinical Psychologist
  • Huntington Woods, MI
  • NPI 1790507465
  NPD (past) Authorized official

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

{
    "created_epoch": "1186617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437523200000",
    "number": "1215128608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44450 PINETREE DR",
            "address_2": "SUITE 101",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481703869",
            "telephone_number": "734-738-0897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44450 PINETREE DR",
            "address_2": "SUITE 101",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481703869",
            "telephone_number": "734-738-0897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAMBERY",
        "first_name": "MICHAEL",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-09",
        "last_updated": "2015-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MI",
            "license": "6301010839",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301010839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Kay Balluff, M.D.
• Balog Speech & Language Center PLLC
• Balog Speech & Language Center, PLLC
• Heather Lynn Balog, PH.D.
• Beverly Bambach
• Gwendolyn Laura Bammel, LMSW
• Janet Banks
• Zahraa Barakat
• Patricia Ann Baran-Bubik, BA
• Lydia Baranyk

• Clinical Psychologist in Plymouth, MI
• Providers in Plymouth, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.