Active NPI
Shagane Nicole Kotcharian, MD
- Student in an Organized Health Care Education/Training Program
- Detroit, MI
National Provider Identifier
1235927682
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 3901 Beaubien Blvd.
Detroit, MI 48201 - Phone
- (313) 745-5146
- NPI assigned
- Apr 28, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
3901 Beaubien Blvd.
Detroit, MI 48201
Mailing address
4201 St. Antoine
Uhc-9C
Detroit, MI 48201
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250528001033 | MI | Order and Referring Only - Pediatric Medicine | 3577082007 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1745798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746144000000",
"number": "1235927682",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4201 ST. ANTOINE",
"address_2": "UHC-9C",
"city": "DETROIT",
"state": "MI",
"postal_code": "48201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3901 BEAUBIEN BLVD.",
"city": "DETROIT",
"state": "MI",
"postal_code": "48201",
"telephone_number": "313-745-5146"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOTCHARIAN",
"first_name": "SHAGANE",
"middle_name": "NICOLE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-04-28",
"last_updated": "2025-05-02",
"certification_date": "2025-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2025; 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.