Edyta Sylwia Krukowska-Urban, PHD, LP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301015110 Issued in MI

Practice address

26850 Providence Pkwy
Suite 410
Novi, MI 48374

Phone

(248) 795-4691

NPI assigned

Apr 4, 2007

Sex

Female

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

Specialty

Clinical Psychologist

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Richard Kneip PHD PCGroup PAC ID 4880768415, 243 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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 and National Provider Directory roles.

• Richard Kneip, PH.D., P.C.

  • Community/Behavioral Health Agency
  • Clarkston, MI
  • NPI 1679739700
  Medicare reassignment Care Compare group NPD
• Henry Ford Health Eastwood Behavioral Health

  • Social Worker
  • Clinton Township, MI
  • NPI 1396787701
  Medicare reassignment NPD

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529366400000",
    "number": "1245352012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26850 PROVIDENCE PKWY",
            "address_2": "SUITE 410",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "48374",
            "telephone_number": "248-795-4691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26850 PROVIDENCE PKWY",
            "address_2": "SUITE 410",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "48374",
            "telephone_number": "248-795-4691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUKOWSKA-URBAN",
        "first_name": "EDYTA",
        "middle_name": "SYLWIA",
        "credential": "PHD, LP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2018-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301015110",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301015110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blair Elyse Krueger
• Kaitlyn Nicole Krueger
• Kelly M Krueger, D.O.
• Staci Lynn Kruger
• Tammy Kruger, CNP
• Malia Krupin
• Julie Kruse
• Barbara Irene Krusen
• Mona Ksar, PHARMD
• Julia Behen Kubek

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.