Individual provider Active NPI

Jyothi Digambaranath, PAC

  • Medical Physician Assistant
  • Detroit, MI
National Provider Identifier
1326701327
Registry record updated Oct 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5601010763 Issued in MI
Practice address
4001 W McNichols Rd
Detroit, MI 48221-3038
Phone
(313) 993-1797
NPI assigned
Oct 16, 2021
Last updated
Oct 16, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5601010763 MI Primary

Addresses

Primary practice location

4001 W McNichols Rd
Detroit, MI 48221-3038

Mailing address

4001 W McNichols Rd
Detroit, MI 48221-3038

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
I20220124000921 MI Practitioner - Physician Assistant 2163814260 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1099 W University Dr
Rochester, MI 48307-1862
Phone (877) 448-3627

15474 N Haggerty Rd
Plymouth, MI 48170-4893
Phone (734) 335-6103

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Infectious Disease Consultants, LLC CurrentSince Jan 17, 2022 Accepting new patients
Metro Infectious Disease Consultants LLC CurrentSince Jan 17, 2022 Accepting new patients
Metro Infectious Disease Consultants, LLC Past Accepting new patients

Locations

901 McClintock Dr
Ste 202
Burr Ridge, IL 60527
Phone (630) 654-4201

7445 Allen Rd
Ste 250
Allen Park, MI 48101
Phone (313) 386-5500

3055 Plymouth Rd
Ste 103
Ann Arbor, MI 48105

7210 N Main St
Ste 103
Clarkston, MI 48346
Phone (248) 620-3376

2549 Jolly Rd
Ste 360
Okemos, MI 48864
Phone (517) 347-2222

15474 N Haggerty Rd
Plymouth, MI 48170
Phone (734) 335-6103

1231 Pine Grove Ave
Ste 1B
Port Huron, MI 48060
Phone (810) 984-8650

18285 E 10 Mile Rd
Ste 150
Roseville, MI 48066
Phone (586) 526-3550

4805 Towne Centre Rd
Ste 103
Saginaw, MI 48604

27209 Lahser Rd
Ste 120
Southfield, MI 48034
Phone (248) 358-4892

43134 Dequindre Rd
Sterling Hts, MI 48314
Phone (586) 446-8688

1851 44th St SW
Ste M
Wyoming, MI 49519

Interoperability endpoints

  • Direct secure messaging: jdigambaranath1125235@direct.hfhs.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1634342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634342400000",
    "number": "1326701327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 W MCNICHOLS RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482213038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 W MCNICHOLS RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482213038",
            "telephone_number": "313-993-1797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIGAMBARANATH",
        "first_name": "JYOTHI",
        "credential": "PAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-16",
        "last_updated": "2021-10-16",
        "certification_date": "2021-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601010763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.