Individual provider Active NPI

Norberto Allende-Jimenez, MD

  • General Practice Physician
  • Detroit, MI
National Provider Identifier
1285723809
Registry record updated May 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
NA061931 Issued in MI
Practice address
5705 W Vernor Hwy
Detroit, MI 48209
Phone
(313) 841-0395
Fax
(313) 841-0580
NPI assigned
Oct 12, 2006
Last updated
May 18, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X NA061931 MI Primary

Addresses

Primary practice location

5705 W Vernor Hwy
Detroit, MI 48209

Mailing address

28700 W 14 Mile Rd
West Bloomfield, MI 48322-4225

Other identifiers 1

IdentifierTypeStateIssuer
3469082MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NA061931MIMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305676800000",
    "number": "1285723809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28700 W 14 MILE RD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483224225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5705 W VERNOR HWY",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48209",
            "telephone_number": "313-841-0395",
            "fax_number": "313-841-0580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLENDE-JIMENEZ",
        "first_name": "NORBERTO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2011-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "NA061931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3469082",
            "state": "MI"
        }
    ],
    "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 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.