Mary Ann Derkacz

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

31815 Southfield Rd Ste 15
Beverly Hills, MI 48025-5471

Phone

(248) 885-8240

NPI assigned

Nov 28, 2016

Last updated

Aug 28, 2019By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Small Talk Centers PLLC

  • Speech-Language Pathologist
  • Beverly Hills, MI
  • NPI 1356876288
  NPD

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

{
    "created_epoch": "1480291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566950400000",
    "number": "1609319573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29846 PLEASANT TRL",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480765719",
            "telephone_number": "248-890-0270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31815 SOUTHFIELD RD STE 15",
            "city": "BEVERLY HILLS",
            "state": "MI",
            "postal_code": "480255471",
            "telephone_number": "248-885-8240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERKACZ",
        "first_name": "MARY ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-28",
        "last_updated": "2019-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eapen Kappammoottil Cherian, PT
• Ross Justin Cooper, M.A., A.T.C., CSCS
• Paul Darmon, D.D.S.
• Erik Dawson, MT
• Jose Andoy Dela Paz
• Francine M Dietsh-Misch, DDS MDS
• Gary Wolk Docks, D.P.M.
• Diane Louise Dolinshek, P.T.
• George Doskoris, D.D.S.
• Michelle Renee Egan, DO

• Speech-Language Pathologist in Beverly Hills, MI
• Providers in Beverly Hills, MI by specialty
• Speech-Language Pathologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.