MR. DAVID DENNIS DERECZYK PA-C NPI 1720158223

NPI Information

  • NPI: 1720158223
  • Provider Name: MR. DAVID DENNIS DERECZYK, PA-C
  • Classification: Physician Assistant - 363AM0700X
  • Specialization: Medical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 2799 W GRAND BLVD
    DETROIT, MI
    ZIP 48202
  • Phone: (313) 916-1557

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NPI Details

MR. David Dennis Dereczyk, PA-C is a medical physician assistant in Detroit, MI. MR. David Dennis Dereczyk, PA-C NPI is 1720158223. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2799 W GRAND BLVD
DETROIT, MI
ZIP 48202-608
Phone: (313) 916-1557

The NPI 1720158223 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Emergency department visit for problem of high severity (HCPCS:99284)

The enumeration date for this NPI number is 11/9/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AM0700XPhysician AssistantMedical001252MICHIGANYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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