Individual provider Active NPI

Nicolin Sofia Oserowsky

  • Student in an Organized Health Care Education/Training Program
  • Chelsea, MI
National Provider Identifier
1861025652
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
4351047494 Issued in MI
Practice address
14700 E Old US Highway 12
Chelsea, MI 48118-1185
Phone
(734) 475-1321
NPI assigned
Feb 19, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Student in an Organized Health Care Education/Training Program 390200000X 4351047494 MI Primary

Addresses

Primary practice location

14700 E Old US Highway 12
Chelsea, MI 48118-1185

Mailing address

1500 East Medical Center Drive
Uh South F-6245
Ann Arbor, MI 48109
Phone (734) 764-6879

Other practice location 1

1500 East Medical Center Drive
UH South F-6245
Ann Arbor, MI 48109
Phone (734) 764-6879

Other names 1

  • Nicolin Sofia Thaler 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
I20210430001380 MI Order and Referring Only - Family PracticePractitioner - Family PracticePractitioner - Psychiatry 8426467523

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1582070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1861025652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 EAST MEDICAL CENTER DRIVE",
            "address_2": "UH SOUTH F-6245",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48109",
            "telephone_number": "734-764-6879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14700 E OLD US HIGHWAY 12",
            "city": "CHELSEA",
            "state": "MI",
            "postal_code": "481181185",
            "telephone_number": "734-475-1321"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 East Medical Center Drive",
            "address_2": "UH South F-6245",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "48109",
            "country_code": "US",
            "telephone_number": "734-764-6879",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OSEROWSKY",
        "first_name": "NICOLIN",
        "middle_name": "SOFIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-19",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4351047494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLIN",
            "last_name": "THALER",
            "middle_name": "SOFIA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chelsea, MI

Sources for this page

Verify at the official NPI Registry.