Organization Active NPI

Albert a. Przybylski, D.O, PC

  • Family Medicine Physician
  • Clinton TWP, MI
National Provider Identifier
1487826020
Registry record updated Mar 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101011659 Issued in MI
Legal business name
ALBERT A. PRZYBYLSKI, D.O, PC
Practice address
36549 Harper Ave
Suite B
Clinton TWP, MI 48035-2012
Phone
(586) 791-3150
Fax
(586) 791-0409
NPI assigned
Mar 24, 2008
Last updated
Mar 24, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2008

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

Authorized official

Name
Albert Anthony Przybylski, D.O.NPI 1013988773
Title
Owner/President
Phone
(586) 791-3150

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 5101011659 MI Primary

Addresses

Primary practice location

36549 Harper Ave
Suite B
Clinton TWP, MI 48035-2012

Mailing address

36549 Harper Ave
Suite B
Clinton TWP, MI 48035-2012
Phone (586) 791-3150

Other identifiers 1

IdentifierTypeStateIssuer
4361360MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100908000613 MI Part B Supplier - Clinic/Group Practice 0244355634 Receives reassigned benefits from 2 practitioners
Practice locations: Clinton TWP, MI

National Provider Directory

National Provider Directory

Locations

36549 Harper Ave
Ste B
Clinton Twp, MI 48035
Phone (586) 791-3150

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1206316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206316800000",
    "number": "1487826020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36549 HARPER AVE",
            "address_2": "SUITE B",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480352012",
            "telephone_number": "586-791-3150",
            "fax_number": "586-791-0409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36549 HARPER AVE",
            "address_2": "SUITE B",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480352012",
            "telephone_number": "586-791-3150",
            "fax_number": "586-791-0409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALBERT A. PRZYBYLSKI, D.O, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-24",
        "last_updated": "2008-03-24",
        "status": "A",
        "authorized_official_last_name": "PRZYBYLSKI",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "586-791-3150",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101011659",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4361360",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton TWP, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.