NPIMap

Individual provider Active NPI

John Imad Jarad, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Port Huron, MI
National Provider Identifier
1245235654
Registry record updated Feb 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
061093 Issued in MI
Practice address
2540 16TH St
Port Huron, MI 48060-6405
Phone
(810) 987-1000
Fax
(810) 982-1810
NPI assigned
Jun 14, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 061093 MI Primary

Addresses

Primary practice location

2540 16TH St
Port Huron, MI 48060-6405

Mailing address

2540 16TH St
Port Huron, MI 48060-6405
Phone (810) 987-1000

Other identifiers 13

IdentifierTypeStateIssuer
0994185OtherMIHEALTHPLUS
G35455OtherMIHAP/CIGNA
0P225700002OtherMIMEDICARE PROVIDER PIN
105910404081OtherMIHUMANA
2366756OtherMIAETNA MEDICARE ADVANTAGE
DG3605OtherMIRAILROAD MEDICARE GROUP PIN
G35455OtherMIALLIANCE HEALTH PLAN
1417675OtherMIUNITED HEALTH CARE
900040508OtherMIPRIORITY HEALTH
110196407OtherMIRAILROAD MEDICARE PROVIDER PIN
1107401082OtherMIBCBSM
1107401082OtherMIMEDICARE PLUS BLUE
4152744MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051024000657 MI Practitioner - Internal Medicine 1456386804 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Port Huron Internal Medicine AssociatesGroup PAC ID 2567497910, 5 clinicians

Practice addresses (Care Compare)

2540 16TH St
Port Huron, MI 48060-6405
Phone (810) 987-1000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
061093MIMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Port Huron Internal Medicine Associates Internal Medicine CurrentSince Jun 1, 1999 Accepting new patients
Marwood Manor Nursing Home Past Accepting new patients

Locations

2540 16th St
Port Huron, MI 48060
Phone (810) 987-1000

2603 Electric Ave
Ste 3
Port Huron, MI 48060
Phone (810) 985-1680

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: jjarad635330@direct.hfhs.org
  • Direct secure messaging: john.jarad.p1@direct.phim.nextgenshare.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Marwood Nursing & RehabPort Huron, MI, CCN 235369 Skilled nursing facility Corporate Director
Operational/Managerial Control
Trustee of the SNF
Adp of the SNF		 Apr 1, 2011
Apr 1, 2011
Apr 1, 2011
Apr 9, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Marwood Manor Nursing Home

    dba Marwood Nursing & Rehab

    • Skilled Nursing Facility
    • Port Huron, MI
    • NPI 1831149855

    Adp of the SNF, Corporate Director, Operational/Managerial Control, Trustee of the SNF

    CMS ownership

Organizations & group practices 2

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 12

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": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423180800000",
    "number": "1245235654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2540 16TH ST",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480606405",
            "telephone_number": "810-987-1000",
            "fax_number": "810-982-1810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2540 16TH ST",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480606405",
            "telephone_number": "810-987-1000",
            "fax_number": "810-982-1810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARAD",
        "first_name": "JOHN",
        "middle_name": "IMAD",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2015-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MI",
            "license": "061093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPLUS",
            "identifier": "0994185",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAP/CIGNA",
            "identifier": "G35455",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER PIN",
            "identifier": "0P225700002",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "105910404081",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA MEDICARE ADVANTAGE",
            "identifier": "2366756",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP PIN",
            "identifier": "DG3605",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALLIANCE HEALTH PLAN",
            "identifier": "G35455",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "1417675",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIORITY HEALTH",
            "identifier": "900040508",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PROVIDER PIN",
            "identifier": "110196407",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "1107401082",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PLUS BLUE",
            "identifier": "1107401082",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4152744",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

Verify at the official NPI Registry.