Active NPI
Celia Sroka, D.O.
- Pediatrics Physician
- Detroit, MI
National Provider Identifier
1487623922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 5101007805
- Practice address
- 17520 Chester St
Detroit, MI 48224-1212 - Phone
- (313) 884-0900
- Fax
- (313) 884-8062
- NPI assigned
- Mar 16, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 5101007805 | MI | Primary |
Addresses
Primary practice location
17520 Chester St
Detroit, MI 48224-1212
Mailing address
16979 Jeanette St
Southfield, MI 48075-1916
Phone (248) 569-1506
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3240753 | Medicaid | MI | |
| 3558201404 | Other | MI | BCBSM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101007805 | MI | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1306454400000",
"number": "1487623922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16979 JEANETTE ST",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480751916",
"telephone_number": "248-569-1506"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17520 CHESTER ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482241212",
"telephone_number": "313-884-0900",
"fax_number": "313-884-8062"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SROKA",
"first_name": "CELIA",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-03-16",
"last_updated": "2011-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MI",
"license": "5101007805",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3240753",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSM",
"identifier": "3558201404",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.