NPIMap

Individual provider Active NPI

Naseer Humayun, M.D.

  • Pediatric Adolescent Medicine Physician
  • Jackson, MI
National Provider Identifier
1104889674
Registry record updated Mar 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
NH033036 Issued in MI
Practice address
720 W Franklin St
Suite One
Jackson, MI 49201-1674
Phone
(517) 784-9104
Fax
(517) 784-9107
NPI assigned
Apr 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NH033036 MI
Pediatric Adolescent Medicine Physician 2080A0000X NH033036 MI Primary

Addresses

Primary practice location

720 W Franklin St
Suite One
Jackson, MI 49201-1674

Mailing address

720 W Franklin St
Suite One
Jackson, MI 49201-1674
Phone (517) 784-9104

Other identifiers 1

IdentifierTypeStateIssuer
1244495-10MedicaidMI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address Nhumayun1@hfhs.org W.A. Foote Memorial Hospital, Inc.
Direct Messaging Address nhumayun444225@direct.hfhs.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
NH033036MIMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Greenwood Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: nhumayun1@hfhs.org
  • Direct secure messaging: nhumayun444225@direct.hfhs.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1104889674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 W FRANKLIN ST",
            "address_2": "SUITE ONE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011674",
            "telephone_number": "517-784-9104",
            "fax_number": "517-784-9107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 W FRANKLIN ST",
            "address_2": "SUITE ONE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011674",
            "telephone_number": "517-784-9104",
            "fax_number": "517-784-9107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMAYUN",
        "first_name": "NASEER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-07",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MI",
            "license": "NH033036",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "MI",
            "license": "NH033036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1244495-10",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Nhumayun1@hfhs.org",
            "affiliation": "Y",
            "affiliationName": "W.A. Foote Memorial Hospital, Inc.",
            "address_1": "205 N East Ave",
            "address_2": "7th FL One Jackson Square",
            "city": "Jackson",
            "state": "MI",
            "country_code": "US",
            "postal_code": "49201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nhumayun444225@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "205 N East Ave",
            "address_2": "7th FL One Jackson Square",
            "city": "Jackson",
            "state": "MI",
            "country_code": "US",
            "postal_code": "49201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.