Organization Active NPI

Debra a. Glitz, M.D., P.L.L.C.

  • Psychiatry Physician
  • Troy, MI
National Provider Identifier
1225102775
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
4301407088 Issued in MI
Legal business name
DEBRA A. GLITZ, M.D., P.L.L.C.
Practice address
3290 W Big Beaver Rd
Suite 509
Troy, MI 48084-2903
Phone
(248) 290-2220
Fax
(248) 290-4019
NPI assigned
Nov 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Debra A Glitz, M.D.NPI 1326086059
Title
Owner
Phone
(248) 290-2220

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 4301407088 MI Primary

Addresses

Primary practice location

3290 W Big Beaver Rd
Suite 509
Troy, MI 48084-2903

Mailing address

3290 W Big Beaver Rd
Suite 509
Troy, MI 48084-2903
Phone (248) 290-2220

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050614000626 MI Part B Supplier - Clinic/Group Practice 8022052737 Receives reassigned benefits from 1 practitioner
Practice locations: Troy, MI; Livonia, MI

National Provider Directory

National Provider Directory

Locations

30400 Telegraph Rd
Ste 324
Bingham Farms, MI 48025
Phone (248) 425-5202

3290 W Big Beaver Rd
Ste 509
Troy, MI 48084
Phone (248) 290-2220

31201 Chicago Rd S
Ste A102
Warren, MI 48093
Phone (586) 795-4750

Practitioners & affiliated clinicians

Practitioners 10

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": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1225102775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3290 W BIG BEAVER RD",
            "address_2": "SUITE 509",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480842903",
            "telephone_number": "248-290-2220",
            "fax_number": "248-290-4019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3290 W BIG BEAVER RD",
            "address_2": "SUITE 509",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480842903",
            "telephone_number": "248-290-2220",
            "fax_number": "248-290-4019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEBRA A. GLITZ, M.D., P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GLITZ",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-290-2220",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301407088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.