Individual provider Active NPI

Diane Buffalin, PH.D.

  • Psychologist
  • Southfield, MI
National Provider Identifier
1568652550
Registry record updated Jul 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6301006295 Issued in MI
Practice address
29260 Franklin Rd. #131
Southfield, MI 48034
Phone
(224) 855-9335
Fax
(248) 357-0102
NPI assigned
Jul 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6301006295 MI Primary

Addresses

Primary practice location

29260 Franklin Rd. #131
Southfield, MI 48034

Mailing address

29260 Franklin Rd. #131
Southfield, MI 48034
Phone (224) 855-9335

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050504000027 MI Practitioner - Clinical Psychologist 5294775862 Practice locations: Farmington Hills, MI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

31811 Middlebelt Rd
Suite 203
Farmington Hills, MI 48334-2368
Phone (248) 559-3359

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6301006295MIMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185408000000",
    "number": "1568652550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29260 FRANKLIN RD. #131",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "48034",
            "telephone_number": "224-855-9335",
            "fax_number": "248-357-0102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29260 FRANKLIN RD. #131",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "48034",
            "telephone_number": "224-855-9335",
            "fax_number": "248-357-0102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUFFALIN",
        "first_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-26",
        "last_updated": "2007-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301006295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.