Individual provider Active NPI

Jonathon Harry Nelson, MD

  • Anesthesiology Physician
  • Detroit, MI
National Provider Identifier
1245539543
Registry record updated Oct 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
4301509942 Issued in MI
Practice address
3901 Beaubien Blvd
Detroit, MI 48201-2916
Phone
(202) 476-2025
NPI assigned
Mar 25, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Anesthesiology Physician 207LP3000X 4301509942 MI
Anesthesiology Physician 207L00000X 4301509942 MI Primary

Addresses

Primary practice location

3901 Beaubien Blvd
Detroit, MI 48201-2916

Mailing address

3901 Beaubien Blvd
Detroit, MI 48201
Phone (313) 745-5535

Other practice location 1

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230920000413 MI Practitioner - Anesthesiology 7012296452 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Loyola University of Chicago, Stritch School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pediatric Anesthesia Associates PCGroup PAC ID 1153483235, 17 clinicians

Practice addresses (Care Compare)

3901 Beaubien St
Detroit, MI 48201-2119
Phone (313) 745-5437

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301509942MIMDPediatric Anesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System CurrentSince Oct 20, 2023 Accepting new patients
Henry Ford Health System Current Accepting new patients
Pediatric Anesthesia Associates, PC Anesthesiology CurrentSince Aug 21, 2023 Accepting new patients
Henry Ford Health System Anesthesiology CurrentSince Oct 20, 2023 Accepting new patients
Children'S Hospital Past Accepting new patients

Locations

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

3901 Beaubien St
Ste 3B17
Detroit, MI 48201
Phone (313) 745-5437

Interoperability endpoints

  • Direct secure messaging: jnelson942917@direct.hfhs.org
  • FHIR API: https://fhir.hfhs.org/FHIRProxy/api/FHIR/R4/

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1301011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1245539543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 BEAUBIEN BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48201",
            "telephone_number": "313-745-5535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 BEAUBIEN BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012916",
            "telephone_number": "202-476-2025"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2799 W Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482022608",
            "country_code": "US",
            "telephone_number": "313-916-2600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "JONATHON",
        "middle_name": "HARRY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-25",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "MI",
            "license": "4301509942",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301509942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.