Active NPI
Fedor Opochinsky
- Psychiatry Physician
- Mount Clemens, MI
National Provider Identifier
1720030968
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 4301063169
- Practice address
- 215 North Ave
Mount Clemens, MI 48043-1716 - Phone
- (586) 466-9939
- Fax
- (586) 466-9956
- NPI assigned
- May 16, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 | 4301063169 | MI | Primary |
Addresses
Primary practice location
215 North Ave
Mount Clemens, MI 48043-1716
Mailing address
PO Box 7987
Bloomfield Hills, MI 48302-7987
Phone (586) 466-9939
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03484552-10 | Medicaid | MI | |
| 2605018311 | Other | BCBSM | |
| FO063169 | Other | MI | LICENSE |
Other names 1
- Fedor Opochinsky
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fedor Opochinsky M.D. | Psychiatry | Past | Accepting new patients |
| Macomb Family Services, Inc | Psychiatry | Past | Accepting new patients |
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/macombfamily/r4/
Organizations & group practices 2
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.
-
- Psychiatry Physician
- Clinton TWP, MI
- NPI 1134155740
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1237248000000",
"number": "1720030968",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7987",
"city": "BLOOMFIELD HILLS",
"state": "MI",
"postal_code": "483027987",
"telephone_number": "586-466-9939",
"fax_number": "586-466-9956"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 NORTH AVE",
"city": "MOUNT CLEMENS",
"state": "MI",
"postal_code": "480431716",
"telephone_number": "586-466-9939",
"fax_number": "586-466-9956"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OPOCHINSKY",
"first_name": "FEDOR",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-16",
"last_updated": "2009-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MI",
"license": "4301063169",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03484552-10",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSM",
"identifier": "2605018311",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "FO063169",
"state": "MI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "FEDOR",
"last_name": "OPOCHINSKY",
"credential": "M.D.",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Mount Clemens, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.