Individual provider Active NPI

Gerald Samuel Kirzner, PHD

  • Clinical Psychologist
  • Farmington Hills, MI
National Provider Identifier
1891866281
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
01846 Issued in MI
Practice address
30600 Northwestern Hwy
Ste 304
Farmington Hills, MI 48334
Phone
(248) 851-8505
NPI assigned
Nov 10, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 01846 MI Primary

Addresses

Primary practice location

30600 Northwestern Hwy
Ste 304
Farmington Hills, MI 48334

Mailing address

30000 Northwestern Hwy
Farmington Hills, MI 48334
Phone (248) 851-8505

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060306000742 MI Practitioner - Clinical Psychologist 8224044870 Practice locations: Farmington Hills, MI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

30000 Northwest Hwy
Farmington Hills, MI 48334-3227

30600 Northwestern Hwy
Suite 304
Farmington Hills, MI 48334-3172
Phone (248) 851-8505

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01846MIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dailey Life, Inc. Past Accepting new patients
Emca Counseling PC PastSince Jun 1, 2013 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891866281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30000 NORTHWESTERN HWY",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "48334",
            "telephone_number": "248-851-8505",
            "fax_number": "248-851-8505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30600 NORTHWESTERN HWY",
            "address_2": "STE 304",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "48334",
            "telephone_number": "248-851-8505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRZNER",
        "first_name": "GERALD",
        "middle_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "01846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

Verify at the official NPI Registry.