Carly Anne Niemczewski, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

4704250178 Issued in MI

Practice address

15474 N Haggerty Rd
Plymouth, MI 48170-4893

Phone

(248) 615-0889

Fax

(734) 404-5317

NPI assigned

Mar 23, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Metro Infectious Disease Consultants LLCGroup PAC ID 3072425784, 386 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joe Mercy Hospital System Livonia Hospital, Livonia, MI, CCN 230002

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Metro Infectious Disease Consultants, LLC

  • Infectious Disease Physician
  • Burr Ridge, IL
  • NPI 1235125717

  MI

  Medicare reassignment Care Compare group NPD
• Metro Infectious Disease Consultants LLC

  • Infectious Disease Physician
  • Jonesboro, GA
  • NPI 1770307191
  NPD
• Metro Infectious Disease Consultants, LLC

  • Infectious Disease Physician
  • Plymouth, MI
  • NPI 1841530250
  NPD (past)

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

• St Mary Mercy Hospital

  • General Acute Care Hospital
  • Livonia, MI
  • NPI 1790706901
  Care Compare affiliation

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

{
    "created_epoch": "1332460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366243200000",
    "number": "1902172976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 MCCLINTOCK DR",
            "address_2": "SUITE 202",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605270871",
            "telephone_number": "888-220-6432",
            "fax_number": "630-734-4715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15474 N HAGGERTY RD",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481704893",
            "telephone_number": "248-615-0889",
            "fax_number": "734-404-5317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEMCZEWSKI",
        "first_name": "CARLY",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-23",
        "last_updated": "2013-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704250178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Nicholson
• Nicole Reynolds PSYD LLC
• Amanda Elizabeth Nicolussi, MOT, OTR/L
• Sophie Niedziolek
• Chelsea Nielson
• Michael Niemi
• Daniel Nieves
• Joshua Nolan
• Shawn Nolan, PT, DPT
• Syeda Noma

• Adult Health Nurse Practitioner in Plymouth, MI
• Providers in Plymouth, MI by specialty
• Adult Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.
• 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.