Individual provider Active NPI

Christian Gjolaj, PA-C

  • Physician Assistant
  • Madison Heights, MI
National Provider Identifier
1376287169
Registry record updated May 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601011133 Issued in MI
Practice address
350 E 12 Mile Rd
Madison Heights, MI 48071-2531
Phone
(248) 716-8600
Fax
(248) 565-8121
NPI assigned
Apr 26, 2022
Last updated
May 20, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601011133 MI Primary

Addresses

Primary practice location

350 E 12 Mile Rd
Madison Heights, MI 48071-2531

Mailing address

350 E 12 Mile Rd
Madison Heights, MI 48071-2531
Phone (248) 716-8600

Other practice location 1

2567 Metro Pkwy
Sterling Heights, MI 48310-7146
Phone (586) 248-5624

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
I20230707002784 MI Practitioner - Physician Assistant 3173982196 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Wayne State University School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Get Well Urgent Care Harper Woods PLCGroup PAC ID 5698145506, 14 clinicians
Roseville Urgent Care PCGroup PAC ID 8921281361, 21 clinicians

Practice addresses (Care Compare)

19959 Vernier Rd
Suite 400
Harper Woods, MI 48225-1423
Phone (313) 499-1951

20769 E 13 Mile Rd
Roseville, MI 48066-4503
Phone (586) 872-2288

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5601011133MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Harper Woods Urgent Care and Medical Center PLLC PastSince Jul 7, 2019 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: cgjolaj727685@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.

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": "1650931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653004800000",
    "number": "1376287169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 E 12 MILE RD",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480712531",
            "telephone_number": "248-716-8600",
            "fax_number": "248-565-8121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 E 12 MILE RD",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480712531",
            "telephone_number": "248-716-8600",
            "fax_number": "248-565-8121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2567 Metro Pkwy",
            "address_purpose": "LOCATION",
            "city": "Sterling Heights",
            "state": "MI",
            "postal_code": "483107146",
            "country_code": "US",
            "telephone_number": "586-248-5624",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GJOLAJ",
        "first_name": "CHRISTIAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-26",
        "last_updated": "2022-05-20",
        "certification_date": "2022-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601011133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison Heights, MI

Sources for this page

Verify at the official NPI Registry.