Active NPI
Michael George Ditsky, PH.D.
- Psychologist
- Sugar Land, TX
National Provider Identifier
1235175985
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 34088
- Practice address
- 7002 River Front Dr
900A
Sugar Land, TX 77479 - Phone
- (281) 770-0826
- Fax
- (281) 656-6621
- NPI assigned
- Jun 21, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 34088 | TX | Primary |
Addresses
Primary practice location
7002 River Front Dr
900A
Sugar Land, TX 77479
Mailing address
2522 Cooling Breeze Dr.
Richmond, TX 77406
Phone (281) 770-0826
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01081201 | Other | PA | CAPITAL BLUE CROSS |
| 412766 | Other | PA | PA BLUE SHIELD |
| 611638 | Other | PA | BC/BS OF MD. CARE FIRST |
| 366298 | Other | PA | VALUE OPTIONS |
| 273439000 | Other | PA | MAGELLAN |
| 2249048 | Other | PA | CIGNA BEHAVIORAL HEALTH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34088 | TX | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391472000000",
"number": "1235175985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2522 COOLING BREEZE DR.",
"city": "RICHMOND",
"state": "TX",
"postal_code": "77406",
"telephone_number": "281-770-0826",
"fax_number": "281-656-6621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7002 RIVER FRONT DR",
"address_2": "900A",
"city": "SUGAR LAND",
"state": "TX",
"postal_code": "77479",
"telephone_number": "281-770-0826",
"fax_number": "281-656-6621"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DITSKY",
"first_name": "MICHAEL",
"middle_name": "GEORGE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-21",
"last_updated": "2014-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "TX",
"license": "34088",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL BLUE CROSS",
"identifier": "01081201",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PA BLUE SHIELD",
"identifier": "412766",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS OF MD. CARE FIRST",
"identifier": "611638",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "366298",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN",
"identifier": "273439000",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA BEHAVIORAL HEALTH",
"identifier": "2249048",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sugar Land, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.