Individual provider Active NPI

Jennifer Syeda, NP

  • Nurse Practitioner
  • Waterford, MI
National Provider Identifier
1245936012
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704361751 Issued in MI
Practice address
4400 Highland Rd Ste 200
Waterford, MI 48328-1222
Phone
(248) 618-6000
NPI assigned
Feb 3, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704361751 MI Primary
Primary Care Nurse Practitioner 363LP2300X 4704361751 MI

Addresses

Primary practice location

4400 Highland Rd Ste 200
Waterford, MI 48328-1222

Mailing address

24 Frank Lloyd Wright Dr # J2000
Ann Arbor, MI 48105-9484
Phone (734) 747-6766

Other practice location 1

624 E 9 Mile Rd
Hazel Park, MI 48030-1842
Phone (248) 629-7497

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
I20230507000080 MI Practitioner - Nurse Practitioner 1355706854 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dearborn Pain Center PLLCGroup PAC ID 7012216732, 5 clinicians

Practice addresses (Care Compare)

624 E 9 Mile Rd
Hazel Park, MI 48030-1842
Phone (248) 629-7497

Hospital & facility affiliations

  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hazel Park Primary Care LLC CurrentSince Feb 13, 2023 Accepting new patients
Dearborn Pain Center PLLC CurrentSince Dec 23, 2024 Accepting new patients

Locations

624 E 9 Mile Rd
Ste B
Hazel Park, MI 48030
Phone (248) 629-7497

624 E 9 Mile Rd
Hazel Park, MI 48030
Phone (248) 268-2566

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 3

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": "1675382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1245936012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DR # J2000",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "telephone_number": "734-747-6766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 HIGHLAND RD STE 200",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483281222",
            "telephone_number": "248-618-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "624 E 9 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Hazel Park",
            "state": "MI",
            "postal_code": "480301842",
            "country_code": "US",
            "telephone_number": "248-629-7497",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SYEDA",
        "first_name": "JENNIFER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-03",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704361751",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "4704361751",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

Verify at the official NPI Registry.