Michael Debacker, MD
Individual provider Active NPI Family Medicine Physician · Pinckney, MI
NPI 1740205111 · NPPES record last updated Dec 9, 2013
Key facts
- NPI
- 1740205111
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 4301061331 (MI)
- Practice address
- 1255 E M-36
Pinckney, MI 48169 - Phone
- (734) 878-1000
- Fax
- (734) 878-1001
- NPI assigned
- Jul 13, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Northeastern Ohio University College of Medicine, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Iha Health Services Corporation
Practice addresses (Care Compare)
1255 E M
Pinckney, MI 48169-8133
Phone (734) 878-1000
128 Van Buren St
Chelsea, MI 48118-1623
Phone (734) 475-8677
20555 Victor Pkwy
Livonia, MI 48152-7031
Hospital & facility affiliations
- Trinity Health at Home- Southeast Michigan
- Trinity Health Ann Arbor Hospital
- Trinity Health Livingston Hospital
- Chelsea Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal or shaving of skin growth | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100108000045 | MI | Practitioner - Family Practice | 2769401769 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301061331 | MI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Iha Health Service Corporation | Current |
Accepting new patients | |
| Iha Health Services Corporation | Current | Accepting new patients | |
| Iha Health Services Corporation | Family Medicine | Current |
Accepting new patients |
| Catherine McAuley Health Services Corporation | Family Medicine | Past | Accepting new patients |
| Iha Health Services Corporation | Family Medicine | Past | Accepting new patients |
Locations
24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400
128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677
620 Byron Rd
Ste 1000
Howell, MI 48843
Phone (517) 545-6618
1255 E M 36
Pinckney, MI 48169
Phone (734) 878-1000
400 W Russell St
Saline, MI 48176
Phone (734) 429-1500
111 N Huron St
Ste 200
Ypsilanti, MI 48197
Phone (734) 480-0033
5361 McAuley Dr
Ypsilanti, MI 48197
Phone (734) 712-1300
5301 McAuley Dr
Ypsilanti, MI 48197
Phone (734) 712-7246
Interoperability endpoints
- mdebacker26009@direct.trinity-health.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 4301061331 | MI | Yes |
Addresses
Primary practice location
1255 E M-36
Pinckney, MI 48169
Mailing address
PO Box 948, Lobby J
24 Frank Lloyd Wright
Ann Arbor, MI 48106-0446
Phone (734) 747-6766
Other providers in Pinckney, MI
- Elisabeth Combs
- Complete Chiropractic & Massage Therapy, PLC
- Christopher Bryan Curtis
- Abby Davenport
- Susan L Davis
- Roberta Anne Denoyer
- Joanne Dodick
- Donald a. Restauri Jr DDS PC
- Stephen Michael Eby
- Evidentiary Psychology
All providers in Pinckney, MI · Family Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 9, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.