Individual provider Active NPI

Cindy Mary Devassy, M.D.

  • Psychiatry Physician
  • Dearborn, MI
National Provider Identifier
1447592019
Registry record updated Jul 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
4301102991 Issued in MI
Practice address
5111 Auto Club Dr Ste 112
Dearborn, MI 48126-2684
Phone
(313) 317-2000
NPI assigned
Mar 21, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 4301102991 MI Primary

Addresses

Primary practice location

5111 Auto Club Dr Ste 112
Dearborn, MI 48126-2684

Mailing address

5111 Auto Club Dr
Ste 112
Dearborn, MI 48126

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20200129001575 IL Practitioner - Psychiatry 1052543766 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
E a Devassy MD and Associates SCGroup PAC ID 4688657067, 2 clinicians

Practice addresses (Care Compare)

16612 W 159TH St
Suite 204
Lockport, IL 60441-8007
Phone (815) 588-3900

Hospital & facility affiliations

  • Saint Joseph Medical Center Hospital, Joliet, IL, CCN 140007

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301102991MIMDPsychiatry Physician

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.

Hospital & facility affiliations 1

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": "1363824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499040000000",
    "number": "1447592019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5111 AUTO CLUB DR",
            "address_2": "STE 112",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "48126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5111 AUTO CLUB DR STE 112",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262684",
            "telephone_number": "313-317-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVASSY",
        "first_name": "CINDY",
        "middle_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-21",
        "last_updated": "2017-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301102991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.