Individual provider Active NPI

Gjergj George Juncaj, NP

  • Family Nurse Practitioner
  • Detroit, MI
National Provider Identifier
1124635917
Registry record updated Nov 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704297541 Issued in MI
Practice address
22101 Moross Rd
Detroit, MI 48236-2148
Phone
(313) 343-4000
NPI assigned
Sep 26, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704297541 MI Primary

Addresses

Primary practice location

22101 Moross Rd
Detroit, MI 48236-2148

Mailing address

1633 Colony Dr
Rochester Hills, MI 48307-3407
Phone (586) 994-9945

Other practice location 1

44201 Dequindre Rd
Troy, MI 48085-1117
Phone (248) 964-8432

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gjuncaj5139880@direct.beaumont.edu

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230209000944 MI Practitioner - Nurse Practitioner 2860864337 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

17900 23 Mile Rd
Macomb, MI 48044-1161

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

22201 Moross Rd
Detroit, MI 48236-2176

46591 Romeo Plank Rd
Suite 137
Macomb, MI 48044-5743
Phone (586) 226-6269

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health St. John Hospital Current Accepting new patients
Henry Ford Health St. John Hospital CurrentSince Oct 16, 2023 Accepting new patients
Henry Ford Health St. John Hospital Nurse Practitioner CurrentSince Oct 16, 2023 Accepting new patients
Beaumont Medical Group- Specialty Services CurrentSince Nov 28, 2022 Accepting new patients
Henry Ford Cornerstone Medical Group Current Accepting new patients
St. John Hospital Past Accepting new patients

Locations

42645 Garfield Rd
Ste 103
Clinton Twp, MI 48038
Phone (586) 286-0050

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

28100 Grand River Ave
Ste 301
Farmington Hills, MI 48336
Phone (947) 521-1320

22201 Moross Rd
Ste 380
Grosse Pointe Woods, MI 48236
Phone (313) 343-4437

46591 Romeo Plank Rd
Macomb, MI 48044
Phone (586) 226-6269

17900 23 Mile Rd
Ste 303
Macomb, MI 48044
Phone (586) 868-9020

44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255

Interoperability endpoints

  • Direct secure messaging: gjuncaj1133862@direct.hfhs.org
  • FHIR API: https://fhir-myrecord.cerner.com/r4/mQjCqHb5rkr1u1foU4dqhQPBpi7Qk9R4/

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 5

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": "1601078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1124635917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1633 COLONY DR",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483073407",
            "telephone_number": "586-994-9945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22101 MOROSS RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482362148",
            "telephone_number": "313-343-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44201 Dequindre Rd",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480851117",
            "country_code": "US",
            "telephone_number": "248-964-8432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JUNCAJ",
        "first_name": "GJERGJ",
        "middle_name": "GEORGE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-26",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704297541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gjuncaj5139880@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "44201 Dequindre Rd",
            "city": "Troy",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480851117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.