Payaum Fotovat-Ahmadi, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

4301512877 Issued in MI

Practice address

27270 Evergreen Rd
Lathrup Village, MI 48076-3249

Phone

(734) 812-0429

NPI assigned

Jun 28, 2023

Last updated

Nov 5, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Physical Medicine and Rehabilitation

Education

Oakland Univ, William Beaumont School of Medicine, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Michigan Rehabilitation PhysiciansGroup PAC ID 4385824382, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Michigan Rehabilitation Physicians

  • Physical Medicine & Rehabilitation Physician
  • Detroit, MI
  • NPI 1215240502
  Medicare reassignment Care Compare group NPD
• Providers Tek Inc.

  • Physical Medicine & Rehabilitation Physician
  • Dearborn, MI
  • NPI 1699283283
  Medicare reassignment NPD
• Riverview Neuromuscular Pain Center PLLC

  • Physical Medicine & Rehabilitation Physician
  • Detroit, MI
  • NPI 1447827894
  Medicare reassignment NPD
• Applebaum Physiatry PLLC

  • Physical Medicine & Rehabilitation Physician
  • Oak Brook, IL
  • NPI 1700598059

  MI

  Medicare reassignment NPD
• Pfa Pain & Rehab Medicine PLLC

  • Physical Medicine & Rehabilitation Physician
  • Lathrup Village, MI
  • NPI 1467397844
  NPD Authorized official
• M&L Quality of Life PLC

  • Physical Medicine & Rehabilitation Physician
  • Farmington Hills, MI
  • NPI 1932733383
  NPD

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

{
    "created_epoch": "1687910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1225715683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27270 EVERGREEN RD",
            "city": "LATHRUP VILLAGE",
            "state": "MI",
            "postal_code": "480763249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27270 EVERGREEN RD",
            "city": "LATHRUP VILLAGE",
            "state": "MI",
            "postal_code": "480763249",
            "telephone_number": "734-812-0429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOTOVAT-AHMADI",
        "first_name": "PAYAUM",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-28",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "4301512877",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "F313676025878",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pfotovatahmadi@oakland.edu",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "27270 Evergreen Rd",
            "city": "Lathrup Village",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480763249",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Focus Diagnostics
• For Your Eyes Only
• Fortson Dental, P.C.
• Fortson Dentistry Lathrup North
• Fortson Family Dentistry, P.C.
• Erin Lee Fox, R.D.
• Renee Fricke, LMT
• Hadassah Friedman
• Ashantae La'Nee' Gary
• Nelvita Gavin

• Physical Medicine & Rehabilitation Physician in Lathrup Village, MI
• Providers in Lathrup Village, MI by specialty
• Physical Medicine & Rehabilitation Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.