Individual provider Active NPI

Janine Ajalat, M.D.

  • Anesthesiology Physician
  • Detroit, MI
National Provider Identifier
1104125392
Registry record updated May 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
4301 098 219 Issued in MI
Practice address
2799 W Grand Blvd
Detroit, MI 48202-2608
Phone
(313) 916-2889
NPI assigned
Mar 28, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 4301 098 219 MI Primary

Addresses

Primary practice location

2799 W Grand Blvd
Detroit, MI 48202-2608

Mailing address

2799 W Grand Blvd
Detroit, MI 48202-2608

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20150921000073 CA Practitioner - Anesthesiology 8224345442 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Michigan State University College of Osteopathic Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bayside Anesthesia Medical GroupGroup PAC ID 2466490560, 47 clinicians
La Quality Care Anesthesia Consultants IncGroup PAC ID 3779706874, 21 clinicians

Practice addresses (Care Compare)

1328 22ND St
St Johns Hospital
Santa Monica, CA 90404-2091
Phone (310) 477-2465

1500 E Chevy Chase Dr
Suite 101
Glendale, CA 91206-4153
Phone (818) 688-0886

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301 098 219MIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
La Quality Care Anesthesia Consultants Inc Anesthesiology CurrentSince Oct 8, 2018 Accepting new patients
Bayside Anesthesia Medical Group CurrentSince Sep 1, 2015 Accepting new patients
Descanso Anesthesia Group Anesthesiology CurrentSince Jul 11, 2022 Accepting new patients

Locations

1812 Verdugo Blvd
Glendale, CA 91208
Phone (818) 246-8000

5700 San Fernando Rd
Glendale, CA 91202
Phone (818) 637-7766

1500 E Chevy Chase Dr
Ste 101
Glendale, CA 91206
Phone (818) 265-1581

1328 22nd St
Santa Monica, CA 90404
Phone (310) 829-5511

Organizations & group practices 3

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 1

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": "1301270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431388800000",
    "number": "1104125392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "313-916-2889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AJALAT",
        "first_name": "JANINE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-28",
        "last_updated": "2015-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301 098 219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.