Individual provider Active NPI

Kamaljeet Bhatia, MD

  • Family Medicine Physician
  • Southfield, MI
National Provider Identifier
1356900393
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301506271 Issued in MI
Practice address
21816 W 11 Mile Rd
Southfield, MI 48076-3724
Phone
(248) 375-4040
Fax
(248) 375-4044
NPI assigned
Jun 12, 2019
Last updated
Mar 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301506271 MI Primary

Addresses

Primary practice location

21816 W 11 Mile Rd
Southfield, MI 48076-3724

Mailing address

21816 W 11 Mile Rd
Southfield, MI 48076-3724
Phone (248) 375-4040

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240304003322 MI Practitioner - Family Practice 9335599596 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dedicated Physicians Group of Michigan, PLLCGroup PAC ID 1153735287, 13 clinicians

Practice addresses (Care Compare)

21832 W 11 Mile Rd
Southfield, MI 48076-3724
Phone (248) 375-4040

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301506271MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dedicated Physicians Group of Michigan PLLC CurrentSince Mar 24, 2024 Accepting new patients
Dedicated Physicians Group of Michigan, PLLC CurrentSince Apr 1, 2024 Accepting new patients
Dedicated Physicians Group of Michigan PLLC PastSince Mar 28, 2021 Accepting new patients

Locations

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

13210 E Jefferson Ave
Detroit, MI 48215
Phone (313) 335-3444

21816 W 11 Mile Rd
Southfield, MI 48076
Phone (248) 375-4040

21832 W 11 Mile Rd
Southfield, MI 48076
Phone (248) 375-4040

Interoperability endpoints

  • Direct secure messaging: kbhatia1025513@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": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1356900393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21816 W 11 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480763724",
            "telephone_number": "248-375-4040",
            "fax_number": "248-375-4044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21816 W 11 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480763724",
            "telephone_number": "248-375-4040",
            "fax_number": "248-375-4044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHATIA",
        "first_name": "KAMALJEET",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-12",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301506271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.