Individual provider Active NPI

Mamta Sharma, MD

  • Infectious Disease Physician
  • Grosse Pointe Woods, MI
National Provider Identifier
1013900570
Registry record updated Jul 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
4301067180 Issued in MI
Practice address
19251 Mack Ave
Grosse Pointe Woods, MI 48236-2893
Phone
(313) 343-7280
Fax
(313) 343-7921
NPI assigned
Aug 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 4301067180 MI Primary

Addresses

Primary practice location

19251 Mack Ave
Grosse Pointe Woods, MI 48236-2893

Mailing address

43800 Garfield Rd
Clinton TWP, MI 48038-1136
Phone (586) 228-4635

Other identifiers 3

IdentifierTypeStateIssuer
4301067180OtherCONTROLLED SUBSTANCE
4466620MedicaidMI
05274626OtherECFMG

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100510000542 MI Practitioner - Infectious DiseasePractitioner - Internal Medicine 6901934132 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Health St. John HospitalGroup PAC ID 3173424082, 332 clinicians

Practice addresses (Care Compare)

19251 Mack Ave
Suite 333
Grosse Pointe Woods, MI 48236-2898
Phone (313) 343-7280

22101 Moross Rd
Detroit, MI 48236-2148
Phone (586) 753-0011

Hospital & facility affiliations

  • Henry Ford Health St John Hospital Hospital, Detroit, MI, CCN 230165
  • Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health St. John Hospital CurrentSince Jan 1, 2003 Accepting new patients
Henry Ford Health St. John Hospital Current Accepting new patients
Henry Ford Health St. John Hospital CurrentSince Jan 1, 2003 Accepting new patients
St. John Hospital Past Accepting new patients
Dietitian for All L.L.C. Past Accepting new patients
Oakwood Healthcare, Inc. Past Accepting new patients

Locations

43800 Garfield Rd
Clinton Twp, MI 48038
Phone (586) 228-4635

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

22101 Moross Rd
Ste 280
Detroit, MI 48236

19251 Mack Ave
Ste 333
Grosse Pointe Woods, MI 48236
Phone (313) 343-7280

19251 Mack Ave
Grosse Pointe Woods, MI 48236
Phone (313) 343-1370

Interoperability endpoints

  • Direct secure messaging: msharma1150994@direct.hfhs.org

Organizations & group practices 6

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215561600000",
    "number": "1013900570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43800 GARFIELD RD",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480381136",
            "telephone_number": "586-228-4635",
            "fax_number": "586-228-4520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19251 MACK AVE",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482362893",
            "telephone_number": "313-343-7280",
            "fax_number": "313-343-7921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARMA",
        "first_name": "MAMTA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-30",
        "last_updated": "2008-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MI",
            "license": "4301067180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONTROLLED SUBSTANCE",
            "identifier": "4301067180",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4466620",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ECFMG",
            "identifier": "05274626",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grosse Pointe Woods, MI

Sources for this page

Verify at the official NPI Registry.