Individual provider Active NPI

Jennifer Lynn Brujitske, NP

  • Acute Care Nurse Practitioner
  • Dearborn Heights, MI
National Provider Identifier
1215035423
Registry record updated Oct 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
4704207537 Issued in MI
Practice address
24430 Ford Rd Ste a
Dearborn Heights, MI 48127-3280
Phone
(313) 565-6782
Fax
(313) 565-6784
NPI assigned
Sep 20, 2006
Last updated
Oct 30, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 4704207537 MI Primary

Addresses

Primary practice location

24430 Ford Rd Ste a
Dearborn Heights, MI 48127-3280

Mailing address

PO Box 670660
Detroit, MI 48267-0660
Phone (866) 321-8433

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
I20050105000994 MI Practitioner - Nurse Practitioner 2860440906 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Interventional Pain Center,PC CurrentSince Nov 11, 2013 Accepting new patients
Shorepointe Emergency Care Physicians PC Past Accepting new patients
TLC of Mi LLC Past Accepting new patients
Anodyne Healthcare PLLC Past Accepting new patients
Integrated Health Group, P.C. Past Accepting new patients

Locations

19725 Allen Rd
Bldg 1
Brownstown Twp, MI 48183
Phone (313) 277-6700

19725 Allen Rd
Ste A
Brownstown Twp, MI 48183
Phone (734) 479-7246

24430 Ford Rd
Ste A
Dearborn Heights, MI 48127
Phone (313) 274-1292

1030 N Monroe St
Monroe, MI 48162
Phone (734) 682-3309

11650 Belleville Rd
Ste 105
Van Buren Township, MI 48111
Phone (734) 325-6282

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351555200000",
    "number": "1215035423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 670660",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482670660",
            "telephone_number": "866-321-8433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24430 FORD RD STE A",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481273280",
            "telephone_number": "313-565-6782",
            "fax_number": "313-565-6784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUJITSKE",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2012-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704207537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn Heights, MI

Sources for this page

Verify at the official NPI Registry.