Active NPI
Jacek Debiec, M.D., PH.D.
- Psychiatry Physician
- Ann Arbor, MI
National Provider Identifier
1841496007
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 4301101970
- Practice address
- 4250 Plymouth Road
Ann Arbor, MI 48109-2700 - Phone
- (734) 764-6443
- Fax
- (734) 763-5580
- NPI assigned
- Jun 25, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Medicine (Psychiatry & Neurology) Physician | 2084A0401X | 4301101970 | MI | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Child & Adolescent Psychiatry Physician | 2084P0804X | 4301101970 | MI | |
| Psychiatry Physician | 2084P0800X | 4301101970 | MI | Primary |
Addresses
Primary practice location
4250 Plymouth Road
Ann Arbor, MI 48109-2700
Mailing address
3621 South State Street
700 KMS Place
Ann Arbor, MI 48108
Phone (734) 936-2047
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301101970 | MI | MD | Psychiatry Physician |
Interoperability endpoints
- jdebiec354448@direct.med.umich.edu
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1358294400000",
"number": "1841496007",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3621 SOUTH STATE STREET",
"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": "4250 PLYMOUTH ROAD",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481092700",
"telephone_number": "734-764-6443",
"fax_number": "734-763-5580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEBIEC",
"first_name": "JACEK",
"name_prefix": "Dr.",
"credential": "M.D., PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-25",
"last_updated": "2013-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "2084A0401X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Addiction Medicine",
"state": "MI",
"license": "4301101970",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "MI",
"license": "4301101970",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MI",
"license": "4301101970",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2013; 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.