Paul Detrisac, MD
NPI 1962506527 · Critical Care Medicine (Internal Medicine) Physician · Niles, MI
Enrolled with Medicare as Practitioner - Internal Medicine · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Paul Detrisac, MD is a Critical Care Medicine (Internal Medicine) Physician provider in Niles, MI (NPI 1962506527).
Provider details
- NPI number
- 1962506527
- Entity type
- Individual
- Primary specialty
- Critical Care Medicine (Internal Medicine) PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- PD043661 (MI)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2006-09-12
- Last updated
- 2007-07-10
Frequently asked questions
- What is Paul Detrisac's NPI number?
- Paul Detrisac's National Provider Identifier (NPI) is 1962506527, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Paul Detrisac's specialty?
- Paul Detrisac is listed in the NPPES registry with a primary specialty of Critical Care Medicine (Internal Medicine) Physician (Allopathic & Osteopathic Physicians).
- Where is Paul Detrisac located?
- Paul Detrisac's practice location on file with NPPES is 24 N St Joseph Ave, Niles, MI 49120.
- What is Paul Detrisac's phone number?
- The practice phone number listed in the NPPES registry for Paul Detrisac is (269) 684-8356.
- Does Paul Detrisac accept Medicare?
- Paul Detrisac is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Paul Detrisac's NPI active?
- Yes — Paul Detrisac's NPI (1962506527) is active in the NPPES registry as of the last update on 2007-07-10.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.