DR. ANDREW JOHN MIELCUSZNY DO
NPI 1629864509
Student in an Organized Health Care Education/Training Program in Detroit, MI

Active since April 16, 2025PECOS Enrolled
2799 W GRAND BLVD, DETROIT, MI 48202(855) 874-7100 Get Directions Write a Review

NPPES record last updated: April 16, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Andrew John Mielcuszny Do NPPES

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

DR. ANDREW JOHN MIELCUSZNY DO (NPI 1629864509) is an individual student in an organized health care education/training program in Detroit, Michigan, licensed in Michigan (5151017286) and active in the NPI registry since April 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1629864509
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. ANDREW JOHN MIELCUSZNYCredential: DO
Location Address2799 W GRAND BLVDDetroit, MI 48202-2689
Mailing Address2799 W Grand BlvdDetroit, MI 48202-2689
Sole ProprietorYes
Enumeration DateApril 16, 2025
NPPES CertifiedApril 16, 2025
NPI 1629864509 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code390200000X
License Licensed in MI · 5151017286
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

2799 W GRAND BLVD, Detroit, MI 48202

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Dr. Andrew John Mielcuszny Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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.

General Acute Care Hospital
2799 W GRAND BLVD
DETROIT, MI 48202
Radiology (Diagnostic Radiology)
2799 W GRAND BLVD
DETROIT, MI 48202
Radiology (Diagnostic Radiology)
2799 W GRAND BLVD
DETROIT, MI 48202
Family Medicine
2799 W GRAND BLVD
DETROIT, MI 48202
Internal Medicine (Pulmonary Disease)
2799 W GRAND BLVD
DETROIT, MI 48202
Internal Medicine (Cardiovascular Disease)
2799 W GRAND BLVD
DETROIT, MI 48202
Nurse Anesthetist, Certified Registered
2799 W GRAND BLVD
DETROIT, MI 48202
Internal Medicine (Pulmonary Disease)
2799 W GRAND BLVD
DETROIT, MI 48202

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 Andrew Mielcuszny's NPI number?

The NPI number for Andrew Mielcuszny is 1629864509. It was assigned to this individual provider in the NPPES registry on April 16, 2025.

Where is Andrew Mielcuszny located?

Andrew Mielcuszny practices at 2799 W Grand Blvd, Detroit, MI 48202. The listed phone number is (855) 874-7100.

What is Andrew Mielcuszny's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Andrew Mielcuszny enrolled in Medicare?

Yes. Andrew Mielcuszny is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Andrew Mielcuszny was last updated on April 16, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.