NPIMap

Individual provider Active NPI

Jane W Ngumo, FNP

  • Family Nurse Practitioner
  • Southfield, MI
National Provider Identifier
1295102192
Registry record updated Apr 14, 2016
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Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704279397 Issued in MI
Practice address
23880 Edinburgh St
Southfield, MI 48033-4891
Phone
(248) 497-6782
NPI assigned
Aug 26, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704279397 MI Primary

Addresses

Primary practice location

23880 Edinburgh St
Southfield, MI 48033-4891

Mailing address

23880 Edinburgh St
Southfield, MI 48033-4891
Phone (248) 497-6782

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
I20160219001094 MI Practitioner - Nurse Practitioner 3870898414 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstreet Urgent Care of MichiganGroup PAC ID 6305188491, 129 clinicians

Practice addresses (Care Compare)

19760 Haggerty Rd
Beaumont Urgent Care of Michigan
Livonia, MI 48152-1080
Phone (734) 793-8769

2078 E Big Beaver Rd
Beaumont Urgent Care of Michigan
Troy, MI 48083-2301
Phone (248) 918-0744

23100 Michigan Ave
Dearborn, MI 48124-2033
Phone (313) 263-7584

27810 Grand River Ave
Farmington Hills, MI 48336-5916
Phone (248) 957-1989

29263 Orchard Lake Rd
Farmington Hills, MI 48334-2953
Phone (248) 488-5900

43535 Grand River Ave
Novi, MI 48375-1108
Phone (248) 946-4500

6470 Orchard Lake Rd
West Bloomfield, MI 48322-2337
Phone (248) 419-8019

6543 Telegraph Rd
Bloomfield Township, MI 48301-3066
Phone (248) 940-4751

Hospital & facility affiliations

  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130
  • Beaumont Hospital - Farmington Hills Hospital, Farmington Hills, MI, CCN 230151

Merit-based Incentive Payment System (MIPS)

Final score
76.04 of 100Reported as group
Quality
67.93
Promoting interoperability
100
Improvement activities
40
Cost
52.21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704279397MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Physicians Medical Group of Michigan, PC CurrentSince Jan 20, 2016 Accepting new patients
Wellstreet Urgent Care of Michigan CurrentSince May 26, 2019 Accepting new patients
Hospitalist Physicians Medical Group of Michigan, PC Nurse Practitioner CurrentSince Jan 20, 2016 Accepting new patients
Wellstreet Urgent Care of Michigan PastSince Aug 6, 2023 Accepting new patients

Locations

2078 E Big Beaver Rd
Troy, MI 48083
Phone (248) 855-4134

2333 Biddle Ave
Wyandotte, MI 48192
Phone (734) 246-6000

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 and National Provider Directory roles.

Hospital & facility affiliations 11

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": "1440547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460592000000",
    "number": "1295102192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23880 EDINBURGH ST",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480334891",
            "telephone_number": "248-497-6782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23880 EDINBURGH ST",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480334891",
            "telephone_number": "248-497-6782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUMO",
        "first_name": "JANE",
        "middle_name": "W",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-26",
        "last_updated": "2016-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704279397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.