Jamal Kriem, MD

Primary specialty

Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X

License

4301084165 Issued in MI

Practice address

3535 W 13 Mile Rd Ste 707
Royal Oak, MI 48073-6770

Phone

(248) 551-0487

Fax

(248) 551-3696

NPI assigned

May 8, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jkriem4655219@direct.beaumont.edu
• Direct secure messaging: jkriem1242429@epic00.shdirect.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Beaumont Medical Group- Specialty Services

  • Surgery Physician
  • Royal Oak, MI
  • NPI 1578072906
  Medicare reassignment NPD
• Covenant Medical Center, Inc.

  • Emergency Medicine Physician
  • Saginaw, MI
  • NPI 1972590412
  Medicare reassignment NPD
• University Pediatricians

  • Pediatrics Physician
  • Detroit, MI
  • NPI 1811920549
  Medicare reassignment NPD
• Covenant Medical Center, Inc

  • Family Medicine Physician
  • Saginaw, MI
  • NPI 1619412376

  Pediatric Gastroenterology

  NPD
• University Pediatricians

  • Pediatrics Physician
  • Detroit, MI
  • NPI 1184471690
  NPD
• William Beaumont Hospital

  • Physician Assistant
  • Royal Oak, MI
  • NPI 1164471983
  NPD (past)
• Mid Dakota Clinic, Inc.

  • Clinic/Center
  • Bismarck, ND
  • NPI 1275587826
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1013120732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 W 13 MILE RD STE 707",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736770",
            "telephone_number": "248-551-0487",
            "fax_number": "248-551-3696"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5415 Cardinal Square Blvd",
            "address_purpose": "LOCATION",
            "city": "Saginaw",
            "state": "MI",
            "postal_code": "486048200",
            "country_code": "US",
            "telephone_number": "989-790-4855",
            "fax_number": "989-790-7335",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "44199 Dequindre Rd Ste 615",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480851128",
            "country_code": "US",
            "telephone_number": "248-964-9660",
            "fax_number": "248-964-9665",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18100 Oakwood Blvd Ste 303",
            "address_purpose": "LOCATION",
            "city": "Dearborn",
            "state": "MI",
            "postal_code": "481244085",
            "country_code": "US",
            "telephone_number": "313-438-7998",
            "fax_number": "313-438-7995",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRIEM",
        "first_name": "JAMAL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301084165",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "MI",
            "license": "4301084165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013120732",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013120732",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkriem87879@direct.covenanthealthcare.com",
            "affiliation": "N",
            "address_1": "5415 Cardinal Square Blvd",
            "city": "Saginaw",
            "state": "MI",
            "country_code": "US",
            "postal_code": "486048200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkriem4655219@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "3535 W 13 Mile Rd Ste 707",
            "city": "Royal Oak",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480736770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jillian Kraydich
• Paul D. Krebsbach, M.D.
• Cynthia L Kresge, P.A.
• Kelly Kretschmann, APRN, NP
• Jennifer Lynn Kreza, M.ED, LBA, BCBA
• Michele Krim
• Priya Krishen, MD
• Anant Krishnan
• Kevin Chandran Krishnan, DO
• Thankamani H. Krishnan, M.D.

• Pediatric Gastroenterology Physician in Royal Oak, MI
• Providers in Royal Oak, MI by specialty
• Pediatric Gastroenterology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.