Active NPI
Manuel Ellis Tancer, MD
- Psychiatry Physician
- Detroit, MI
National Provider Identifier
1578500062
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 4301064220
- Practice address
- 3901 Chrysler Service Dr.
Detroit, MI 48201-2167 - Phone
- (313) 993-3434
- Fax
- (313) 993-3421
- NPI assigned
- Jun 1, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 4301064220 | MI | Primary |
Addresses
Primary practice location
3901 Chrysler Service Dr.
Detroit, MI 48201-2167
Mailing address
1560 E Maple Rd
Suite 400-Credentialing
Troy, MI 48083-1138
Phone (313) 993-3434
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301064220 | MI | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Physician Group | Psychiatry | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474588800000",
"number": "1578500062",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1560 E MAPLE RD",
"address_2": "SUITE 400-CREDENTIALING",
"city": "TROY",
"state": "MI",
"postal_code": "480831138",
"telephone_number": "313-993-3434",
"fax_number": "313-993-3421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3901 CHRYSLER SERVICE DR.",
"city": "DETROIT",
"state": "MI",
"postal_code": "482012167",
"telephone_number": "313-993-3434",
"fax_number": "313-993-3421"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANCER",
"first_name": "MANUEL",
"middle_name": "ELLIS",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-01",
"last_updated": "2016-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MI",
"license": "4301064220",
"primary": true
}
],
"identifiers": [],
"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 Sep 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.