Individual provider Active NPI

Michael Holtzman

  • School Social Worker
  • Ann Arbor, MI
National Provider Identifier
1336756253
Registry record updated Sep 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Social WorkerTaxonomy code 1041S0200X
Practice address
3008 Brockman Blvd
Ann Arbor, MI 48104-4717
Phone
(734) 358-1259
NPI assigned
Sep 24, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X Primary

Addresses

Primary practice location

3008 Brockman Blvd
Ann Arbor, MI 48104-4717

Mailing address

3008 Brockman Blvd
Ann Arbor, MI 48104-4717
Phone (734) 358-1259

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240718000086 MI Practitioner - Clinical Social Worker 1557807245 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Key Development Center, Inc.Group PAC ID 0244602530, 4 clinicians

Practice addresses (Care Compare)

2418 E Grand River Ave
Howell, MI 48843-7787
Phone (810) 220-8192

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Key Development Center, Inc. CurrentSince Jul 15, 2024 Accepting new patients

Locations

2418 E Grand River Ave
Howell, MI 48843
Phone (810) 220-8192

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.

NPI Registry JSON

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

{
    "created_epoch": "1600905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600905600000",
    "number": "1336756253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3008 BROCKMAN BLVD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481044717",
            "telephone_number": "734-358-1259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3008 BROCKMAN BLVD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481044717",
            "telephone_number": "734-358-1259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLTZMAN",
        "first_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-24",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.