University Pediatricians
Organization Active NPI Psychologist · Detroit, MI
NPI 1124265335 · NPPES record last updated Dec 8, 2022
Key facts
- NPI
- 1124265335
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychologist 103T00000X
- Legal business name
- UNIVERSITY PEDIATRICIANS
- Practice address
- 3901 Beaubien St
Detroit, MI 48201-2119 - Phone
- (313) 966-5051
- Fax
- (313) 966-6618
- NPI assigned
- Jan 9, 2009
- Reactivated
- Dec 8, 2022
- Organization subpart
- No
Authorized official
- Name
- Ms. Yolanda Brown
- Title
- Provider Services Representative
- Phone
- (313) 966-5051
Other NPIs on the same Medicare enrollment 4
Practitioners 29
-
Sanjeev Aggarwal, M.D.
-
Ayesha Ahmad, MBBS
-
Dima Al Ta'Any, MD
-
Rajan Arora, MD
-
Kenghia Billings, MD
-
Melissa February, MD
-
Sam S. Gabbara, M.D.
-
Kimberly Renee Houchard, M.D.
-
Amrish Jain, M.D.
-
Gaurav Kapur, MD
-
Aimee F Luat, M.D.
-
Baqir Ali Malik, MD
-
Monica Maka Nafsou, D.O.
-
Chenni S Sriram, M.D.
-
Nadia Tremonti, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040115000125 | MI | Part B Supplier - Clinic/Group Practice | 9638070568 |
Receives reassigned benefits from 370 practitioners 4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Troy, MI; Detroit, MI |
National Provider Directory
Locations
4201 Saint Antoine St
#6F
Detroit, MI 48201
Phone (313) 745-7329
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist |
103T00000X | Yes |
Addresses
Primary practice location
3901 Beaubien St
Detroit, MI 48201-2119
Mailing address
4201 Saint Antoine St
University Health Center 6F Mailbox #226
Detroit, MI 48201-2153
Phone (313) 966-5051
Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 8, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.