Individual provider Active NPI

Shelly A Stettner, DO

  • Psychiatry Physician
  • Detroit, MI
National Provider Identifier
1972540466
Registry record updated May 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
5101008475 Issued in MI
Practice address
3901 Chrysler Dr
Detroit, MI 48201-2167
Phone
(313) 577-1396
Fax
(313) 993-3421
NPI assigned
Jun 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 5101008475 MI Primary

Addresses

Primary practice location

3901 Chrysler Dr
Detroit, MI 48201-2167

Mailing address

1560 E Maple Rd
Suite 400- Credentialing
Troy, MI 48083-1135
Phone (313) 993-3434

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
I20060705000221 MI Practitioner - PsychiatryPractitioner - Neuropsychiatry 7810909199 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Drake University College of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Physician GroupGroup PAC ID 8628087681, 399 clinicians

Practice addresses (Care Compare)

16836 Newburgh Rd
Suite 27
Livonia, MI 48154-1600
Phone (734) 464-4220

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101008475MIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Group CurrentSince Oct 6, 2016 Accepting new patients
University Physician Group Psychiatry Past Accepting new patients

Locations

4100 John R St
Detroit, MI 48201
Phone (313) 576-8530

4201 Saint Antoine St
#9B
Detroit, MI 48201
Phone (313) 745-1060

4201 Saint Antoine St
Detroit, MI 48201
Phone (313) 745-3615

16836 Newburgh Rd
Livonia, MI 48154
Phone (734) 464-4220

1560 E Maple Rd
Ste 200
Troy, MI 48083
Phone (248) 581-5200

1560 E Maple Rd
Ste 400
Troy, MI 48083

Interoperability endpoints

  • Direct secure messaging: sstettne@direct.dmc.org

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496102400000",
    "number": "1972540466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 E MAPLE RD",
            "address_2": "SUITE 400- CREDENTIALING",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831135",
            "telephone_number": "313-993-3434",
            "fax_number": "313-993-3421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 CHRYSLER DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012167",
            "telephone_number": "313-577-1396",
            "fax_number": "313-993-3421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STETTNER",
        "first_name": "SHELLY",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-01",
        "last_updated": "2017-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "5101008475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.