Individual provider Active NPI

Anthony David Diloreto, PMHNP, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Waterford, MI
National Provider Identifier
1437495298
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4704267277 Issued in MI
Practice address
4576 W Walton Blvd
Waterford, MI 48329-4905
Phone
(248) 618-3920
NPI assigned
Dec 26, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4704277277 MI
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4704267277 MI Primary

Addresses

Primary practice location

4576 W Walton Blvd
Waterford, MI 48329-4905

Mailing address

4576 W Walton Blvd
Waterford, MI 48329-4905

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
I20141027001887 MI Practitioner - Nurse Practitioner 7810118312 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704267277MIMDPsychiatric/Mental Health Nurse Practitioner
4704277277MIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Healthcare Professionals PC CurrentSince Oct 14, 2024 Accepting new patients
Michigan Healthcare Professionals, P.C. CurrentSince Oct 14, 2024 Accepting new patients
Oakland Health Associate of Waterford Clarkston CurrentSince Apr 19, 2025 Accepting new patients
Michigan Healthcare Professionals PC Current Accepting new patients
New Image Body and Wellness Clinic, PC PastSince Sep 5, 2023 Accepting new patients

Locations

5701 Bow Pointe Dr
Ste 380
Clarkston, MI 48346
Phone (248) 241-6514

27900 Grand River Ave
Ste 220
Farmington Hills, MI 48336
Phone (248) 477-0552

29992 Northwestern Hwy
Ste C
Farmington Hills, MI 48334
Phone (248) 851-1430

44555 Woodward Ave
Ste 405
Pontiac, MI 48341
Phone (248) 333-7100

44405 Woodward Ave
Pontiac, MI 48341
Phone (248) 858-3000

4576 W Walton Blvd
Waterford, MI 48329
Phone (248) 618-3920

Interoperability endpoints

  • Direct secure messaging: anthonydiloreto@oha.direct.kno2fy.com

Organizations & group practices 5

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": "1356480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1437495298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4576 W WALTON BLVD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483294905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4576 W WALTON BLVD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483294905",
            "telephone_number": "248-618-3920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILORETO",
        "first_name": "ANTHONY",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "PMHNP, RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-12-26",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704277277",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704267277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

Verify at the official NPI Registry.