Individual provider Active NPI

Lyndsey Muklewicz, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Grosse Pointe Farms, MI
National Provider Identifier
1245845304
Registry record updated Oct 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4704275051 Issued in MI
Practice address
131 Kercheval Ave Ste 390
Grosse Pointe Farms, MI 48236-3628
Phone
(313) 885-6400
NPI assigned
Sep 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4704275051 MI Primary

Addresses

Primary practice location

131 Kercheval Ave Ste 390
Grosse Pointe Farms, MI 48236-3628

Mailing address

131 Kercheval Ave Ste 390
Grosse Pointe Farms, MI 48236-3628
Phone (586) 615-4959

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231116003219 MI Practitioner - Nurse Practitioner 6608223334 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pure Psychiatry of Michigan PLLCGroup PAC ID 1254741283, 102 clinicians

Practice addresses (Care Compare)

28345 Beck Rd
Suite 110
Wixom, MI 48393-4733
Phone (248) 274-4560

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pure Psychiatry of Michigan PLLC CurrentSince Oct 15, 2023 Accepting new patients
Sanjeev Venkataraman, MD, PLC CurrentSince Feb 20, 2026 Accepting new patients
Positive Images PastSince Sep 1, 2020 Accepting new patients

Locations

W-4111 Andover Rd
Ste 100
Bloomfield Township, MI 48302
Phone (248) 290-5400

2422 Jolly Rd
Ste 100A
Okemos, MI 48864
Phone (517) 853-1358

34841 Veterans Plz
Wayne, MI 48184
Phone (313) 292-7640

28345 Beck Rd
Ste 110
Wixom, MI 48393
Phone (248) 274-4560

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633046400000",
    "number": "1245845304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 KERCHEVAL AVE STE 390",
            "city": "GROSSE POINTE FARMS",
            "state": "MI",
            "postal_code": "482363628",
            "telephone_number": "586-615-4959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 KERCHEVAL AVE STE 390",
            "city": "GROSSE POINTE FARMS",
            "state": "MI",
            "postal_code": "482363628",
            "telephone_number": "313-885-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUKLEWICZ",
        "first_name": "LYNDSEY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-14",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704275051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grosse Pointe Farms, MI

Sources for this page

Verify at the official NPI Registry.