NPIMap

Organization Active NPI

Great Lakes Psychiatric Associates, PLLC

  • Psychiatry Physician
  • Farmington Hills, MI
National Provider Identifier
1811452113
Registry record updated Jul 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
GREAT LAKES PSYCHIATRIC ASSOCIATES, PLLC
Practice address
28580 Orchard Lake Rd Ste 104
Farmington Hills, MI 48334-2988
Phone
(248) 865-7271
Fax
(248) 865-7274
NPI assigned
Jan 31, 2019
Last updated
Jul 2, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2026

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

Authorized official

Name
Manzar Rajput, MDNPI 1851358527
Title
Owner
Phone
(734) 678-7450

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

28580 Orchard Lake Rd Ste 104
Farmington Hills, MI 48334-2988

Mailing address

28580 Orchard Lake Rd Ste 104
Farmington Hills, MI 48334-2988
Phone (734) 678-7450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190219003265 MI Part B Supplier - Clinic/Group Practice 0749528636 Receives reassigned benefits from 8 practitioners
Practice locations: Farmington Hills, MI; Jackson, MI; Monroe, MI

National Provider Directory

National Provider Directory

Locations

569 Wildwood Ave
Unit 3
Jackson, MI 49201
Phone (248) 865-7271

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1548892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782950400000",
    "number": "1811452113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28580 ORCHARD LAKE RD STE 104",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483342988",
            "telephone_number": "734-678-7450",
            "fax_number": "248-865-7271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28580 ORCHARD LAKE RD STE 104",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483342988",
            "telephone_number": "248-865-7271",
            "fax_number": "248-865-7274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES PSYCHIATRIC ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-31",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "status": "A",
        "authorized_official_last_name": "RAJPUT",
        "authorized_official_first_name": "MANZAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-678-7450",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.