Jerome Sitner, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

JS005168 Issued in MI

Practice address

4771 Michigan Ave
Detroit, MI 48210-3247

Phone

(313) 897-2600

Fax

(313) 897-2424

NPI assigned

Jan 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Junction Clinic

  • Family Medicine Physician
  • Detroit, MI
  • NPI 1285813154
  Medicare reassignment NPD
• Sciometrix LLC

  • General Practice Physician
  • Royal Oak, MI
  • NPI 1619649894
  Medicare reassignment NPD
• Sciometrix Inc

  • General Practice Physician
  • Staten Island, NY
  • NPI 1457065591
  NPD

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193616000000",
    "number": "1164492500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4771 MICHIGAN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482103247",
            "telephone_number": "313-897-2600",
            "fax_number": "313-897-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4771 MICHIGAN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482103247",
            "telephone_number": "313-897-2600",
            "fax_number": "313-897-2424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SITNER",
        "first_name": "JEROME",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2007-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "JS005168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERICAL NUMBERS",
            "identifier": "381886254",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "0P01030",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1117984",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI INDIVIDUAL",
            "identifier": "1164492500",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL #S",
            "identifier": "P0103003",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NUMBERS",
            "identifier": "0858218024",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI # GROUP",
            "identifier": "1285813154",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sistas of Compassion
• Sister 2 Sister Home Healthcare Corp
• Andrea Sisti, MD
• Peter Sisung
• Natraj Sitaram, MD
• Srividhya Sivanandan
• Mohana Sivasankaran, PHARMACY TECHNICIAN
• Six Mile Medical Pharmacy, LLC
• Six Mile Medical, PLLC
• Six Mile Pharmacy LLC

• Family Medicine Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.