DR. LORIEN PATRICE SHACK (MD) – Addiction Medicine (Internal Medicine) Physician, NPI 1164710406
Addiction Medicine (Internal Medicine) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
96 ADDICTION MEDICINE in MI
Provider Addresses for DR. LORIEN PATRICE SHACK (MD)
6071 WEST OUTER DRIVE
DETROIT, MI 48235
Phone:
Type: Mailing
6071 W OUTER DR
DETROIT, MI 482352624
Phone: (313) 966-3155
Type: Location
24 FRANK LLOYD WRIGHT DR STE J2000
ANN ARBOR, MI 481059484
Phone: (734) 747-6766
Fax: (734) 222-3100
Type: Mailing
5333 MCAULEY DR. SUITE 5011
YPSILANTI, MI 48197
Phone: (734) 712-8700
Fax: (734) 622-5017
Type: Location
24 FRANK LLOYD WRIGHT DR
SUITE J2000
ANN ARBOR, MI 48105
Phone: (734) 747-6766
Fax: (734) 222-3100
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-05-20
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240520001476 | I | Addiction Medicine | MI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 48235)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Hospitalist, Internal Medicine | MI | |
| Interventional Radiology | MI | |
| Cardiovascular Disease (Cardiology) | MI | |
| Physician Assistant | MI | |
| Physician Assistant | MI | |
| - | MI | |
| - | MI | |
| Internal Medicine, Geriatric Medicine | MI | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MI | |
| Hospitalist, Internal Medicine | MI |
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