NPIMap

Individual provider Active NPI

Samar Mumtaz, MD

  • Internal Medicine Physician
  • Royal Oak, MI
National Provider Identifier
1346403243
Registry record updated Feb 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301091757 Issued in MI
Practice address
2033 Crooks Rd
Royal Oak, MI 48073-4049
Phone
(248) 543-2000
NPI assigned
Jul 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301091757 MI Primary

Addresses

Primary practice location

2033 Crooks Rd
Royal Oak, MI 48073-4049

Mailing address

30000 Northwestern Hwy
Farmington Hills, MI 48334-3227

Other practice location 1

17392 W 13 Mile Rd
Beaumont Beverly Hills Internal Medicine
Beverly Hills, MI 48025-5438
Phone (248) 646-8166

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address smumtaz23860@direct.beaumont.edu

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
I20110719000082 MI Practitioner - Internal Medicine 9830367846 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Michigan Healthcare Professionals PCGroup PAC ID 0345413258, 525 clinicians

Practice addresses (Care Compare)

29877 Telegraph Rd
Suite 200
Southfield, MI 48034-7659
Phone (248) 354-0730

Hospital & facility affiliations

  • Residential Home Health Home health agency, Troy, MI, CCN 237459
  • Beaumont Home Health Home health agency, Troy, MI, CCN 237112
  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130
  • Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269
  • Beaumont Hospital - Farmington Hills Hospital, Farmington Hills, MI, CCN 230151
  • Beaumont Hospital - Dearborn Hospital, Dearborn, MI, CCN 230020

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301091757MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Memorial Joint Operating Company Past Accepting new patients
William Beaumont Hospital Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: smumtaz23860@direct.beaumont.edu

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 and National Provider Directory roles.

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1346403243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30000 NORTHWESTERN HWY",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483343227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2033 CROOKS RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480734049",
            "telephone_number": "248-543-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17392 W 13 Mile Rd",
            "address_2": "Beaumont Beverly Hills Internal Medicine",
            "address_purpose": "LOCATION",
            "city": "Beverly Hills",
            "state": "MI",
            "postal_code": "480255438",
            "country_code": "US",
            "telephone_number": "248-646-8166",
            "fax_number": "248-646-8176",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUMTAZ",
        "first_name": "SAMAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-10",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301091757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smumtaz23860@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "17392 W 13 Mile Rd",
            "address_2": "Beaumont Beverly Hills Internal Medicine",
            "city": "Beverly Hills",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480255438",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.