Individual provider Active NPI

Justin K Liegmann, MD

  • Psychiatry Physician
  • Grand Blanc, MI
National Provider Identifier
1750513099
Registry record updated Mar 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
4301097584 Issued in MI
Practice address
5445 Ali Dr Dept 320
Grand Blanc, MI 48439-5193
Phone
(810) 428-1181
Fax
(810) 426-0009
NPI assigned
Aug 20, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X 4301097584 MI
Psychiatry Physician 2084P0800X ME160935 FL
Psychiatry Physician 2084P0800X 4301097584 MI Primary

Addresses

Primary practice location

5445 Ali Dr Dept 320
Grand Blanc, MI 48439-5193

Mailing address

5445 Ali Dr Dept 320
Grand Blanc, MI 48439-5193
Phone (810) 428-2011

Other practice location 1

130 S University Dr
Plantation, FL 33324-3357
Phone (954) 634-7966

Other practice location 2

541 Cedar Hill Ave
Wyckoff, NJ 07481-2150
Phone (508) 221-6805

Other identifiers 1

IdentifierTypeStateIssuer
4301097584OtherMILICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20131002000618 MI Practitioner - Psychiatry 6800020983 Reassigns benefits to 2 organizations
I20241002000071 NJ Practitioner - Psychiatry 6800020983 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cognosis Health HillsideGroup PAC ID 5890158901, 15 clinicians

Practice addresses (Care Compare)

10761 S Saginaw St
Suite D
Grand Blanc, MI 48439-8168
Phone (810) 428-1181

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME160935FLMDPsychiatry Physician
4301097584MIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cognosis Health Psychiatry CurrentSince Jun 26, 2023 Accepting new patients
Cognosis Health Hillside Psychiatry CurrentSince Aug 1, 2023 Accepting new patients
Cognosis Psychiatry CurrentSince Sep 1, 2024 Accepting new patients
Genesys Practice Partners, Inc. Past Accepting new patients
Cognosis Health PastSince Jun 29, 2025 Accepting new patients

Locations

5445 Ali Dr
#340
Grand Blanc, MI 48439
Phone (551) 444-0924

5445 Ali Dr
Grand Blanc, MI 48439
Phone (810) 428-1181

5445 Ali Dr
#320
Grand Blanc, MI 48439
Phone (810) 428-1181

5445 Ali Dr
Dept 330
Grand Blanc, MI 48439
Phone (551) 444-0924

541 Cedar Hill Ave
Ste 2
Wyckoff, NJ 07481
Phone (201) 212-6735

Interoperability endpoints

  • Direct secure messaging: jliegmann1139243@direct.hfhs.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1250726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773878400000",
    "number": "1750513099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5445 ALI DR DEPT 320",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484395193",
            "telephone_number": "810-428-2011",
            "fax_number": "810-426-0009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5445 ALI DR DEPT 320",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484395193",
            "telephone_number": "810-428-1181",
            "fax_number": "810-426-0009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 S University Dr",
            "address_purpose": "LOCATION",
            "city": "Plantation",
            "state": "FL",
            "postal_code": "333243357",
            "country_code": "US",
            "telephone_number": "954-634-7966",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "541 Cedar Hill Ave",
            "address_purpose": "LOCATION",
            "city": "Wyckoff",
            "state": "NJ",
            "postal_code": "074812150",
            "country_code": "US",
            "telephone_number": "508-221-6805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIEGMANN",
        "first_name": "JUSTIN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-20",
        "last_updated": "2026-03-19",
        "certification_date": "2026-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "MI",
            "license": "4301097584",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME160935",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301097584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "4301097584",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Blanc, MI

Sources for this page

Verify at the official NPI Registry.