Individual provider Active NPI

Paul Witri, LLMSW

  • Clinical Social Worker
  • Walled Lake, MI
National Provider Identifier
1669942785
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801101607 Issued in MI
Practice address
1010 E West Maple Rd
Walled Lake, MI 48390-3571
Phone
(248) 313-2908
NPI assigned
Dec 1, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801101607 MI Primary

Addresses

Primary practice location

1010 E West Maple Rd
Walled Lake, MI 48390-3571

Mailing address

23237 Providence Dr Apt 208
Southfield, MI 48075-3618
Phone (616) 581-3719

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pcerecords.essmichigan@direct.mihin.net Easterseals MORC Health Care, Inc.

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
I20211210000553 MI Practitioner - Clinical Social Worker 6002206802 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801101607MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Easterseals Morc Health Care, Inc. CurrentSince Aug 25, 2021 Accepting new patients

Locations

2399 E Walton Blvd
Auburn Hills, MI 48326
Phone (248) 475-6400

22170 W 9 Mile Rd
Southfield, MI 48033
Phone (248) 357-8197

1010 E West Maple Rd
Walled Lake, MI 48390
Phone (248) 313-2900

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": "1543622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1669942785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23237 PROVIDENCE DR APT 208",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753618",
            "telephone_number": "616-581-3719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 E WEST MAPLE RD",
            "city": "WALLED LAKE",
            "state": "MI",
            "postal_code": "483903571",
            "telephone_number": "248-313-2908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITRI",
        "first_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-01",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801101607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pcerecords.essmichigan@direct.mihin.net",
            "affiliation": "Y",
            "affiliationName": "Easterseals MORC Health Care, Inc.",
            "address_1": "2399 E Walton Blvd",
            "city": "Auburn Hills",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483261955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Walled Lake, MI

Sources for this page

Verify at the official NPI Registry.