NPIMap

Individual provider Active NPI

Julie Samantray, MD MPH

  • Endocrinology, Diabetes & Metabolism Physician
  • Detroit, MI
National Provider Identifier
1285832451
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
4301083617 Issued in MI
Practice address
4201 Saint Antoine St
Suite 5a
Detroit, MI 48201-2153
Phone
(313) 745-4525
Fax
(313) 993-0085
NPI assigned
Jul 10, 2007
Last updated
Mar 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301083617 MI
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 4301083617 MI Primary

Addresses

Primary practice location

4201 Saint Antoine St
Suite 5a
Detroit, MI 48201-2153

Mailing address

400 Mack Ave
Detroit, MI 48201-2136

Other practice location 1

400 Mack Ave
Detroit, MI 48201-2136
Phone (313) 448-9650

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
I20071217000491 MI Practitioner - EndocrinologyPractitioner - Internal Medicine 8123118999 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Physician GroupGroup PAC ID 8628087681, 399 clinicians

Practice addresses (Care Compare)

4201 Saint Antoine St
Detroit, MI 48201-2153
Phone (313) 745-4525

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Group Internal Medicine CurrentSince Sep 25, 2007 Accepting new patients
University Physician Group CurrentSince Sep 25, 2007 Accepting new patients
University Physician Group Past Accepting new patients
University Physician Group Past Accepting new patients

Locations

400 Mack Ave
Detroit, MI 48201
Phone (313) 448-9006

4100 John R St
Detroit, MI 48201
Phone (313) 576-8530

4201 Saint Antoine St
#5A
Detroit, MI 48201

4201 Saint Antoine St
Ste 5A
Detroit, MI 48201
Phone (313) 966-2492

26400 W 12 Mile Rd
Ste 111
Southfield, MI 48034
Phone (248) 357-4151

1560 E Maple Rd
Ste 200
Troy, MI 48083
Phone (248) 581-5200

1560 E Maple Rd
Ste 400
Troy, MI 48083

Interoperability endpoints

  • Direct secure messaging: julie.samantray.1@19711.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646092800000",
    "number": "1285832451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MACK AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 SAINT ANTOINE ST",
            "address_2": "SUITE 5A",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "313-745-4525",
            "fax_number": "313-993-0085"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Mack Ave",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012136",
            "country_code": "US",
            "telephone_number": "313-448-9650",
            "fax_number": "313-448-9979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMANTRAY",
        "first_name": "JULIE",
        "credential": "MD MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-10",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301083617",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MI",
            "license": "4301083617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.