Active NPI
Theresa Brietzke, APRN
- Family Nurse Practitioner
- Detroit, MI
National Provider Identifier
1770399925
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 4704419360
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11035309 | FL | MD | Family Nurse Practitioner |
| 4704419360 | MI | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sacred Heart Medical Centre PC | Current | Accepting new patients | |
| Kamran F. Sheikh MD PC | Current | 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.
-
- Family Medicine Physician
- Farmington, MI
- NPI 1205862513
-
- Family Medicine Physician
- Farmington Hills, MI
- NPI 1558588772
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2026; 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.