Individual provider Active NPI

Theresa Brietzke, APRN

  • Family Nurse Practitioner
  • Detroit, MI
National Provider Identifier
1770399925
Registry record updated Jun 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704419360 Issued in MI
Practice address
2799 W Grand Blvd
Detroit, MI 48202-2608
Phone
(313) 916-1841
Fax
(313) 916-8270
NPI assigned
Dec 3, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704419360 MI Primary
Family Nurse Practitioner 363LF0000X 11035309 FL

Addresses

Primary practice location

2799 W Grand Blvd
Detroit, MI 48202-2608

Mailing address

1 Ford PL Ste 3a
Detroit, MI 48202-3450
Phone (800) 999-5829

Other practice location 1

744 Peppervine Ave
Saint Johns, FL 32259-5272
Phone (240) 449-5014

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241219000779 MI Practitioner - Nurse Practitioner 2567999279 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11035309FLMDFamily Nurse Practitioner
4704419360MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Medical Centre PC CurrentSince Dec 5, 2024 Accepting new patients
Kamran F. Sheikh MD PC CurrentSince Jan 1, 2026 Accepting new patients

Locations

8623 N Telegraph Rd
Ste 1
Dearborn Hts, MI 48127
Phone (313) 561-4540

29201 Telegraph Rd
Ste 404
Southfield, MI 48034
Phone (248) 355-0880

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.

NPI Registry JSON

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

{
    "created_epoch": "1733184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782086400000",
    "number": "1770399925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FORD PL STE 3A",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023450",
            "telephone_number": "800-999-5829",
            "fax_number": "313-876-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "313-916-1841",
            "fax_number": "313-916-8270"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "744 Peppervine Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Johns",
            "state": "FL",
            "postal_code": "322595272",
            "country_code": "US",
            "telephone_number": "240-449-5014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRIETZKE",
        "first_name": "THERESA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-03",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704419360",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11035309",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.