Individual provider Active NPI

Danielle Wyzgoski, DO

  • Pediatrics Physician
  • Sterling Heights, MI
National Provider Identifier
1841853173
Registry record updated Jun 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
5101026731 Issued in MI
Practice address
14500 Hall Rd
Sterling Heights, MI 48313-1229
Phone
(586) 247-2700
NPI assigned
Apr 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X 5101026731 MI
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 5101026731 MI Primary

Addresses

Primary practice location

14500 Hall Rd
Sterling Heights, MI 48313-1229

Mailing address

412 E Sunnybrook Dr
Royal Oak, MI 48073-2635
Phone (248) 320-6291

Other practice location 1

3901 Beaubien St
Detroit, MI 48201-2119
Phone (313) 745-5533

Other names 1

  • Danielle Erin Gittleman Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220621002232 MI Practitioner - Pediatric Medicine 6406180504 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101026731MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Macomb Hospital Corporation CurrentSince Jun 15, 2022 Accepting new patients
Henry Ford Health System Pediatrics CurrentSince Jun 15, 2022 Accepting new patients
Henry Ford Macomb Hospital Corporation Pediatrics CurrentSince Jun 15, 2022 Accepting new patients
Henry Ford Macomb Hospital Corporation Pediatrics Current Accepting new patients
Henry Ford Health System CurrentSince Jun 15, 2022 Accepting new patients
Henry Ford Health System Current Accepting new patients
Henry Ford Health System Past Accepting new patients

Locations

15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2300

15717 15 Mile Rd
Clinton Twp, MI 48035
Phone (586) 285-3800

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-2892

14500 Hall Rd
Sterling Hts, MI 48313
Phone (586) 247-2700

6777 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 325-1000

Interoperability endpoints

  • Direct secure messaging: dwyzgoski728748@direct.hfhs.org

Organizations & group practices 7

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": "1555891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1841853173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 E SUNNYBROOK DR",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480732635",
            "telephone_number": "248-320-6291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14500 HALL RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483131229",
            "telephone_number": "586-247-2700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3901 Beaubien St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012119",
            "country_code": "US",
            "telephone_number": "313-745-5533",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYZGOSKI",
        "first_name": "DANIELLE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-22",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "MI",
            "license": "5101026731",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "5101026731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELLE",
            "last_name": "GITTLEMAN",
            "middle_name": "ERIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sterling Heights, MI

Sources for this page

Verify at the official NPI Registry.