Mary Carol Blazek, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

4301078784 Issued in MI

Practice address

4260 Plymouth Rd
Ann Arbor, MI 48109-2700

Phone

(734) 936-4400

NPI assigned

Jan 15, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

PsychiatryAlso: Geriatric Psychiatry

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Regents of the University of MichiganGroup PAC ID 3779496856, 3,344 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Michigan Health System Hospital, Ann Arbor, MI, CCN 230046

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as apm

Quality

85.92

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Regents of the University of Michigan

  • Psychiatry Physician
  • Ann Arbor, MI
  • NPI 1770518839
  Medicare reassignment Care Compare group NPD
• Regents of the University of Michigan

  • Specialty Pharmacy
  • Dexter, MI
  • NPI 1952181919
  NPD
• Chelsea Community Hospital

  • Clinical Psychologist
  • Chelsea, MI
  • NPI 1356440689

  Psychiatry

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Regents of the University of Michigan

  • General Acute Care Hospital
  • Ann Arbor, MI
  • NPI 1003878539
  Care Compare affiliation

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283299200000",
    "number": "1831240118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "address_2": "700 KMS PLACE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48108",
            "telephone_number": "734-936-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4260 PLYMOUTH RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481092700",
            "telephone_number": "734-936-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAZEK",
        "first_name": "MARY",
        "middle_name": "CAROL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-15",
        "last_updated": "2010-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MI",
            "license": "4301078784",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301078784",
            "primary": true
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "MI",
            "license": "4301078784",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104334765",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GRP",
            "identifier": "260H161260",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Rose Blase, MD, PH.D.
• Mary Gail Blasier, ANP
• Melanie S Blasingim, CRNA
• Daniel W Blaszczyk, CRNA
• Michael Andrew Blatt, MD
• Brooke Blazius, D.O.
• Stephen Michael Blazoff, CRNA
• Christopher Blazy, PHARMD
• Alyssa Bleitz
• Bradley Josph Blitstein, DDS

• Psychiatry Physician in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2010; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.