Individual provider Active NPI

Ajwad Bajwa, M.D.

  • Diagnostic Radiology Physician
  • Royal Oak, MI
National Provider Identifier
1023378767
Registry record updated Apr 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
036.142851 Issued in IL
Practice address
3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone
(248) 551-0424
NPI assigned
May 28, 2012
Last updated
Apr 6, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 4301100590 MI
Diagnostic Radiology Physician 2085R0202X 036.142851 IL Primary

Addresses

Primary practice location

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712

Mailing address

1740 W Taylor St
Chicago, IL 60612-7232
Phone (866) 600-2273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN, OH3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20180531000642 IL Practitioner - Diagnostic Radiology 7315178282 Reassigns benefits to 2 organizations
I20210624001901 IN Practitioner - Diagnostic Radiology 7315178282 Reassigns benefits to 3 organizations
I20210628002545 OH Practitioner - Diagnostic Radiology 7315178282 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Northwestern University Feinberg Medical School, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fort Wayne Radiology Associates LLCGroup PAC ID 5294624060, 35 clinicians
Breast Diagnostic Center LLCGroup PAC ID 9335189513, 8 clinicians

Practice addresses (Care Compare)

1035 W Wayne St
Paulding, OH 45879-1544
Phone (419) 399-4080

3707 New Vision Dr
Fort Wayne, IN 46845-1702
Phone (260) 969-1124

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.142851ILMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fort Wayne Radiology Associates LLC Diagnostic Radiology CurrentSince Aug 1, 2021 Accepting new patients
Community Hospitals and Wellness Centers CurrentSince Aug 1, 2021 Accepting new patients
Community Hospitals and Wellness Centers CurrentSince Aug 1, 2021 Accepting new patients
Integrated Imaging Consultants LLC Diagnostic Radiology CurrentSince Mar 4, 2018 Accepting new patients
Rockford Radiology Assoc Diagnostic Radiology CurrentSince Jul 9, 2018 Accepting new patients
Breast Diagnostic Center, LLC Diagnostic Radiology CurrentSince Aug 1, 2021 Accepting new patients
P E T Imaging Services LLC Diagnostic Radiology CurrentSince Apr 19, 2025 Accepting new patients

Locations

1420 Renaissance Dr
Ste 307
Park Ridge, IL 60068
Phone (847) 803-1000

1775 W Dempster St
Park Ridge, IL 60068
Phone (847) 723-5150

5666 E State St
Rockford, IL 61108
Phone (815) 226-2000

1818 Carew St
Ste 30
Fort Wayne, IN 46805
Phone (260) 425-5900

2110 Carew St
Fort Wayne, IN 46805
Phone (219) 432-6710

2200 Randallia Dr
Fort Wayne, IN 46805
Phone (260) 373-4000

3707 New Vision Dr
Fort Wayne, IN 46845
Phone (260) 373-4000

1355 Mariners Dr
Warsaw, IN 46582
Phone (574) 267-6778

121 Westfield Dr
Archbold, OH 43502
Phone (419) 445-2015

433 W High St
Bryan, OH 43506
Phone (419) 636-1131

909 E Snyder Ave
Montpelier, OH 43543
Phone (419) 485-3154

1035 W Wayne St
Paulding, OH 45879
Phone (419) 399-4080

Organizations & group practices 7

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

Hospital & facility affiliations 6

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": "1338163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491436800000",
    "number": "1023378767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 W TAYLOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127232",
            "telephone_number": "866-600-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 W 13 MILE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736712",
            "telephone_number": "248-551-0424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAJWA",
        "first_name": "AJWAD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-28",
        "last_updated": "2017-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301100590",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036.142851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.