Individual provider Active NPI

Michal Purzycki

  • Psychologist
  • Detroit, MI
National Provider Identifier
1780370528
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6362009988 Issued in MI
Practice address
62 W 7 Mile Rd
Detroit, MI 48203-1967
Phone
(313) 893-6172
NPI assigned
Apr 14, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6362009988 MI Primary

Addresses

Primary practice location

62 W 7 Mile Rd
Detroit, MI 48203-1967

Mailing address

62 W 7 Mile Rd
Detroit, MI 48203-1967

Other identifiers 1

IdentifierTypeStateIssuer
3434247MedicaidMI

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6362009988MIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Arab American and Chaldean Council Past Accepting new patients

Organizations & group practices 1

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": "1681430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1780370528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 W 7 MILE RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482031967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 W 7 MILE RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482031967",
            "telephone_number": "313-893-6172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURZYCKI",
        "first_name": "MICHAL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-14",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6362009988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3434247",
            "state": "MI"
        }
    ],
    "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 Sep 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.