Active NPI
Daniel T Obrien, PA
- Medical Physician Assistant
- Detroit, MI
National Provider Identifier
1255434155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 5601001300
- Practice address
- 4646 John R St
11M
Detroit, MI 48201-1916 - Phone
- (313) 576-3724
- NPI assigned
- Sep 6, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 5601001300 | MI | Primary |
Addresses
Primary practice location
4646 John R St
11M
Detroit, MI 48201-1916
Mailing address
43350 Tyler Rd
Belleville, MI 48111-4330
Phone (313) 576-3724
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130412000046 | MI | Order and Referring Only - Physician Assistant | 9133365406 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1255434155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "43350 TYLER RD",
"city": "BELLEVILLE",
"state": "MI",
"postal_code": "481114330",
"telephone_number": "313-576-3724"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4646 JOHN R ST",
"address_2": "11M",
"city": "DETROIT",
"state": "MI",
"postal_code": "482011916",
"telephone_number": "313-576-3724"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OBRIEN",
"first_name": "DANIEL",
"middle_name": "T",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "MI",
"license": "5601001300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
- Chinwe Obioha
- Jacob Oblak, MD
- Ehita Nkem Oboh
- Rosela Beth Obregon
- Mark Obri, MD
- Observation Emergency Physicians, P.C.
- Occupational Health Centers of Michigan P.C.
- Occupational Health Centers of Michigan, P.C.
- Occupational Health Centers of Michigan, P.C.
- Occupational Health Centers of Michigan, P.C.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.