Individual provider Active NPI

Judith Marie Paskiewicz, PHD

  • Psychologist
  • Birmingham, MI
National Provider Identifier
1922165265
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6301008361 Issued in MI
Practice address
800 N Old Woodward Ave Ste 210
Birmingham, MI 48009-3802
Phone
(248) 642-3337
Fax
(248) 642-3224
NPI assigned
Jan 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801009862 MI
Psychologist 103T00000X 6301008361 MI Primary

Addresses

Primary practice location

800 N Old Woodward Ave Ste 210
Birmingham, MI 48009-3802

Mailing address

600 N Old Woodward
Suite 300
Birmingham, MI 48009
Phone (248) 642-3337

Other identifiers 3

IdentifierTypeStateIssuer
0F33001OtherMIBCBS
023727OtherVALUE OPTIONS
5047088OtherAETNA

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
I20090827000689 MI Practitioner - Clinical Psychologist 8628123593 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

950 E Maple Rd
Suite 214
Birmingham, MI 48009-6411
Phone (248) 642-3337

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6301008361MIMDPsychologist
6801009862MIMDSocial Worker

Organizations & group practices 1

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": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1922165265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N OLD WOODWARD",
            "address_2": "SUITE 300",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "48009",
            "telephone_number": "248-642-3337",
            "fax_number": "248-642-3224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N OLD WOODWARD AVE STE 210",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480093802",
            "telephone_number": "248-642-3337",
            "fax_number": "248-642-3224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASKIEWICZ",
        "first_name": "JUDITH",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801009862",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301008361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0F33001",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "023727",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5047088",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, MI

Sources for this page

Verify at the official NPI Registry.