Cheryl M Mazzara, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

4301051598 Issued in MI

Practice address

19900 E 10 Mile Rd Ste 102
Saint Clair Shores, MI 48080-4412

Phone

(586) 776-3366

Fax

(586) 776-3369

NPI assigned

Jul 21, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Psychiatry

Education

Wayne State University School of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Henry Ford Health Eastwood Behavioral Health

  dba Eastwood Clinics

  • Social Worker
  • Clinton Township, MI
  • NPI 1396787701
  NPD (past)
• Laura McMahon MD PC

  • Psychiatry Physician
  • Shelby TWP, MI
  • NPI 1114087426
  NPD (past)

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349913600000",
    "number": "1497776025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19900 E 10 MILE RD STE 102",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480804412",
            "telephone_number": "586-776-3366",
            "fax_number": "586-776-3369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19900 E 10 MILE RD STE 102",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480804412",
            "telephone_number": "586-776-3366",
            "fax_number": "586-776-3369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZARA",
        "first_name": "CHERYL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2012-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301051598",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "2605015512",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alma Maurer
• Laura Susan Maurer, LMSW
• Anne Maynard
• Mazen Khalidi MD PC
• Gabriela Mazur, DO
• Patrick M McCabe, M.A., L.L.P.
• Lydia J McCafferty
• Deborah Shawntae McCall
• Anne Marie B McCarren, M.D.
• Lauren McCloy, PT, DPT

• Psychiatry Physician in Saint Clair Shores, MI
• Providers in Saint Clair Shores, MI by specialty
• Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.