AMY DERECZYK PA-C
NPI 1558349050
Physician Assistant in Detroit, MI

Active since January 04, 2006
4001 W MCNICHOLS RD, DETROIT, MI 48221(313) 993-1797(313) 993-1271 Get Directions Write a Review

NPPES record last updated: May 10, 2011. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Amy Dereczyk Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AMY DERECZYK PA-C (NPI 1558349050) is an individual physician assistant in Detroit, Michigan, licensed in Michigan (5601003980) and active in the NPI registry since January 2006.

NPPES Registry Identity

NPI1558349050
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameAMY DERECZYKCredential: PA-C
Location Address4001 W MCNICHOLS RDDetroit, MI 48221-3038
Mailing Address4001 W Mcnichols RdDetroit, MI 48221-3038 · (313) 993-1797 · Fax (313) 993-1271
Fax(313) 993-1271
Sole ProprietorNo
Enumeration DateJanuary 4, 2006
Last NPPES UpdateMay 10, 2011
NPI 1558349050 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in MI · 5601003980
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
4001 W MCNICHOLS RD, Detroit, MI 48221

Other Identifiers 3

Medicare ID-Type UnspecifiedN86630007MI · Pec Okw (pas)
Other11712511Caqh
Medicare ID-Type UnspecifiedP00043337MI · Railroad

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Registered Nurse
4001 W MCNICHOLS RD
DETROIT, MI 48221
Physician Assistant
4001 W MCNICHOLS RD
DETROIT, MI 48221
Physician Assistant
4001 W MCNICHOLS RD
DETROIT, MI 48221
Physician Assistant
4001 W MCNICHOLS RD
DETROIT, MI 48221
Specialist/Technologist (Athletic Trainer)
4001 W MCNICHOLS RD
DETROIT, MI 48221
Nurse Anesthetist, Certified Registered
4001 W MCNICHOLS RD
DETROIT, MI 48221
Student in an Organized Health Care Education/Training Program
4001 W MCNICHOLS RD
DETROIT, MI 48221
Registered Nurse
4001 W MCNICHOLS RD
DETROIT, MI 48221

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Amy Dereczyk's NPI number?

The NPI number for Amy Dereczyk is 1558349050. It was assigned to this individual provider in the NPPES registry on January 4, 2006.

Where is Amy Dereczyk located?

Amy Dereczyk practices at 4001 W Mcnichols Rd, Detroit, MI 48221. The listed phone number is (313) 993-1797.

What is Amy Dereczyk's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Amy Dereczyk was last updated on May 10, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.