Active NPI
Mary Catherine Delucia, WHCNP
- Women's Health Nurse Practitioner
- Southgate, MI
National Provider Identifier
1245218528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- 4704127749
- Practice address
- 15675 Northline Rd
Southgate, MI 48195-2334 - Phone
- (734) 282-3600
- Fax
- (734) 282-3603
- NPI assigned
- Jan 6, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | 4704127749 | MI | Primary |
Addresses
Primary practice location
15675 Northline Rd
Southgate, MI 48195-2334
Mailing address
1640 Fort St
Suite D Attn: Denise
Trenton, MI 48183-2040
Phone (734) 391-3057
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0H28865 | Other | MI | BLUE CROSS |
| 1144634403 | Other | GROUP NPI HENRY FORD WYANDOTTE |
Other names 1
- Mary Catherine Pelak
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)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oakwood Group IX, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Dearborn, MI
- NPI 1720050917
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487635200000",
"number": "1245218528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1640 FORT ST",
"address_2": "SUITE D ATTN: DENISE",
"city": "TRENTON",
"state": "MI",
"postal_code": "481832040",
"telephone_number": "734-391-3057",
"fax_number": "734-391-3052"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15675 NORTHLINE RD",
"city": "SOUTHGATE",
"state": "MI",
"postal_code": "481952334",
"telephone_number": "734-282-3600",
"fax_number": "734-282-3603"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELUCIA",
"first_name": "MARY",
"middle_name": "CATHERINE",
"name_prefix": "Mrs.",
"credential": "WHCNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-06",
"last_updated": "2017-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "MI",
"license": "4704127749",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "0H28865",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI HENRY FORD WYANDOTTE",
"identifier": "1144634403",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MARY",
"last_name": "PELAK",
"middle_name": "CATHERINE",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Southgate, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.