Derek Stodolak

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

4301508955 Issued in MI

Practice address

10300 W 8 Mile Rd
Ferndale, MI 48220-2100

Phone

(248) 398-3200

Fax

(248) 691-4963

NPI assigned

Jun 24, 2019

Sex

Male

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dstodolak573228@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.

• State of Michigan Office of Financial Management

  • Nursing Facility/Intermediate Care Facility
  • Grand Rapids, MI
  • NPI 1710989298
  Medicare reassignment NPD
• State of Michigan Office of Financial Management

  • Psychiatric Hospital
  • Saline, MI
  • NPI 1003859380
  NPD
• State of Michigan Office of Financial Management

  • Skilled Nursing Facility
  • Chesterfield, MI
  • NPI 1497342653
  NPD

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

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1689235459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10300 W 8 MILE RD",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482202100",
            "telephone_number": "248-398-3200",
            "fax_number": "248-691-4963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10300 W 8 MILE RD",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482202100",
            "telephone_number": "248-398-3200",
            "fax_number": "248-691-4963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STODOLAK",
        "first_name": "DEREK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-24",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301508955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Diponio Therapy & Consulting
• Stephanie Williams, PHD, LP, PLLC
• Dionne Stewart, LMT
• Rachel Renee Stewart, LLPC, ATR-P
• Tara Lynn Stock, DPM
• Jessica Leigh Stoey, RDN
• Lisa Christine Strzempek
• Amber Sufi
• Rachel Marie Suidan, CNM
• Super Value Pharmacy

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.