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DOUGLAS SHOTSKY PC
NPI 1770829376
Counselor - Professional in Adrian, MI

Active since December 31, 2012PECOS Enrolled
1040 S WINTER ST STE 1022, ADRIAN, MI 49221(517) 264-0142(517) 263-7616 Get Directions Write a Review

NPPES record last updated: April 2, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 2, 2026, Oct 1, 2024 (2 updates tracked since 2024).

About Douglas Shotsky Pc NPPES

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

DOUGLAS SHOTSKY PC (NPI 1770829376) is an individual professional provider in Adrian, Michigan, licensed in Ohio (C1000391) and active in the NPI registry since December 2012. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1770829376
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameDOUGLAS SHOTSKYCredential: PC
Location Address1040 S WINTER ST STE 1022Adrian, MI 49221-3876
Mailing Address1040 S Winter St Ste 1022Adrian, MI 49221-3876 · (517) 264-0142 · Fax (517) 263-7616
Phone(517) 264-0142
Fax(517) 263-7616
Sole ProprietorNo
Enumeration DateDecember 31, 2012
Last NPPES UpdateApril 2, 20262 updates tracked since enumeration
NPPES CertifiedApril 2, 2026
✔ NPI 1770829376 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
Licenses✔ Licensed in OH · C1000391✔ Licensed in MI · 6401224320
1040 S WINTER ST STE 1022, Adrian, MI 49221
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Douglas Shotsky Pc 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.

Medicare Billing Reassignments

2

Medicare enrollment records show Douglas Shotsky reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mental Health Specialty Group PA
491 mi
Mental Health
110 N CORCORAN ST FL 5
Durham, NC 27701
  • Reassigned Medicare billing, Ohio enrollment
  • 130 clinicians in this Medicare group
NPI 1801472634 (323) 205-7088
Grow Healthcare Group PA
1,132 mi
Mental Health
66 W FLAGLER ST STE 900
Miami, FL 33130
  • Reassigned Medicare billing, Michigan and Ohio enrollments
  • 411 clinicians in this Medicare group
NPI 1245845932 (786) 244-7711

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

SHEILA SEARS
Case Manager/Care Coordinator
1040 S WINTER ST STE 1022
ADRIAN, MI 49221
Lenawee County (517) 263-8905
SARAH MARIE RICKARD
Peer Specialist
1040 S WINTER ST STE 1022
ADRIAN, MI 49221
Lenawee County (517) 264-0152
HEATHER KAY BROWN
Peer Specialist
1040 S WINTER ST STE 1022
ADRIAN, MI 49221
Lenawee County (517) 263-8905
KRISTIN MARIE FOREST
Social Worker
1040 S WINTER ST STE 1022
ADRIAN, MI 49221
Lenawee County (517) 263-8905
ALEXAH GRACE OMEAUX
Peer Specialist
1040 S WINTER ST STE 1022
ADRIAN, MI 49221
Lenawee County (517) 263-8905
MS. HEATHER RUTH PETTY BSW
Case Manager/Care Coordinator
1040 S WINTER ST STE 1022
ADRIAN, MI 49221
Lenawee County (517) 264-0120
SAMANTHA GOOD QMHS
Social Worker
1040 S WINTER ST STE 1022
ADRIAN, MI 49221
Lenawee County (517) 263-8905
MISS ASHLEY ELIZABETH GIGAX
Peer Specialist
1040 S WINTER ST STE 1022
ADRIAN, MI 49221
Lenawee County (517) 263-8905

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 Douglas Shotsky's NPI number?

The NPI number for Douglas Shotsky is 1770829376. It was assigned to this individual provider in the NPPES registry on December 31, 2012.

Where is Douglas Shotsky located?

Douglas Shotsky practices at 1040 S Winter St Ste 1022, Adrian, MI 49221. The listed phone number is (517) 264-0142.

What is Douglas Shotsky's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Douglas Shotsky enrolled in Medicare?

Yes. Douglas Shotsky is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Douglas Shotsky's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Douglas Shotsky reassigns Medicare benefits to 2 organizations: Mental Health Specialty Group PA (Durham, NC) and Grow Healthcare Group PA (Miami, FL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Douglas Shotsky's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Douglas Shotsky accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and Blue Care Network of Michigan and 6 other insurers list Douglas Shotsky as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Douglas Shotsky was last updated on April 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.