Individual provider Active NPI

Agnieszka Z Smylnycky, MD

  • Family Medicine Physician
  • Troy, MI
National Provider Identifier
1346250578
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301080644 Issued in MI
Practice address
2891 E Maple Rd
Suite 102
Troy, MI 48083-6106
Phone
(248) 524-9085
Fax
(248) 524-9086
NPI assigned
Aug 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301080644 MI Primary

Addresses

Primary practice location

2891 E Maple Rd
Suite 102
Troy, MI 48083-6106

Mailing address

2891 E Maple Rd Ste 102
Troy, MI 48083-6106
Phone (248) 635-5988

Other identifiers 1

IdentifierTypeStateIssuer
104949279MedicaidMI

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070314000181 MI Practitioner - Family Practice 9931202827 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lily's Medical Group PLLCGroup PAC ID 8628514627, 2 clinicians

Practice addresses (Care Compare)

37300 Dequindre Rd
Suite 102
Sterling Heights, MI 48310-3595
Phone (586) 838-4291

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Lilys Medical Group PLLC Family Medicine CurrentSince Jun 18, 2024 Accepting new patients

Locations

37300 Dequindre Rd
Ste 102
Sterling Hts, MI 48310
Phone (248) 766-4977

Interoperability endpoints

  • Direct secure messaging: asmylnycky1151904@direct.hfhs.org

Organizations & group practices 2

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1346250578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2891 E MAPLE RD STE 102",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480836106",
            "telephone_number": "248-635-5988",
            "fax_number": "485-249-0862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2891 E MAPLE RD",
            "address_2": "SUITE 102",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480836106",
            "telephone_number": "248-524-9085",
            "fax_number": "248-524-9086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMYLNYCKY",
        "first_name": "AGNIESZKA",
        "middle_name": "Z",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301080644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104949279",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.