Jessica Ann Depetro, DO, MSC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

5151014796APP21 Issued in MI

Practice address

26091 Beaumont Blvd.
D3-1708
Southfield, MI 48033

Phone

(947) 522-3088

NPI assigned

Jun 11, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Michigan State University College of Osteopathic Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Health Oakland Hospital Hospital, Pontiac, MI, CCN 230029

Merit-based Incentive Payment System (MIPS)

Final score

93.79 of 100Reported as group

Quality

90.17

Promoting interoperability

83

Improvement activities

40

Cost

86.64

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jdepetro699680@direct.trinity-health.org
• Direct secure messaging: jdepetro1231119@epic00.shdirect.org
• Direct secure messaging: jdepetro604643@direct.hfhs.org

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.

• Iha Health Services Corporation

  • Obstetrics & Gynecology Physician
  • Canton, MI
  • NPI 1457408965
  Medicare reassignment Care Compare group NPD
• Easterseals Morc Health Care, Inc.

  • Psychiatry Physician
  • Auburn Hills, MI
  • NPI 1376526616
  Medicare reassignment NPD
• Iha Health Service Corporation

  • Obstetrics & Gynecology Physician
  • Ypsilanti, MI
  • NPI 1831053701
  NPD
• Iha Health Services Corporation

  • Psychiatry Physician
  • Ypsilanti, MI
  • NPI 1164137709
  NPD
• The Mel Bornstein Clinic for Psychoanalysis and Psychotherapy

  • Multi-Specialty Clinic/Center
  • Farmington Hills, MI
  • NPI 1023546389
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Joseph Mercy Hospital-SMHC

  • General Acute Care Hospital
  • Pontiac, MI
  • NPI 1053356352
  Care Compare affiliation

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

{
    "created_epoch": "1623369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1528636008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26091 BEAUMONT BLVD.",
            "address_2": "D3-1708",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "48033",
            "telephone_number": "947-522-3088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26091 BEAUMONT BLVD.",
            "address_2": "D3-1708",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "48033",
            "telephone_number": "947-522-3088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPETRO",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "DO, MSC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-11",
        "last_updated": "2021-06-11",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "5151014796APP21",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Ann Denryter, PT
• Joi Dent
• Dental Rehab PC
• Dentalexpress.Net, LLC
• Dependable Home Health Care,LLC
• Jerry Depoy
• Derosa Plastic Surgery, PLLC
• Kaya Tala Derosia
• Emily Dertien
• Shaileshkumar K Desai, MD

• Psychiatry Physician in Southfield, MI
• Providers in Southfield, MI by specialty
• Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2021; 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.