Individual provider Active NPI

Hirva Mansurali Mamdani, M.D.

  • Hematology & Oncology Physician
  • Detroit, MI
National Provider Identifier
1437446820
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
4301098222 Issued in MI
Practice address
4100 John R St
Detroit, MI 48201-2013
Phone
(800) 527-6266
Fax
(313) 576-8627
NPI assigned
Jul 6, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301098222 MI
Hematology & Oncology Physician 207RH0003X 4301098222 MI Primary

Addresses

Primary practice location

4100 John R St
Detroit, MI 48201-2013

Mailing address

1891 Kirts Blvd
Apt 210
Troy, MI 48084
Phone (909) 525-0093

Other practice location 1

535 Barnhill Dr
Indianapolis, IN 46202-5116
Phone (909) 525-0093

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
I20170829001958 MI Practitioner - Hematology/OncologyPractitioner - Internal Medicine 4183840945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

4100 John R St
Detroit, MI 48201-2013
Phone (800) 527-6266

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301098222MIMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Barbara Ann Karmanos Cancer Institute CurrentSince Aug 1, 2017 Accepting new patients
Barbara Ann Karmanos Cancer Institute CurrentSince Aug 1, 2017 Accepting new patients
Barbara Ann Karmanos Cancer Institute Past Accepting new patients

Locations

4100 John R St
Detroit, MI 48201
Phone (313) 576-8530

31995 Northwestern Hwy
Farmington Hills, MI 48334
Phone (248) 538-4701

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 2

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": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1437446820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1891 KIRTS BLVD",
            "address_2": "APT 210",
            "city": "TROY",
            "state": "MI",
            "postal_code": "48084",
            "telephone_number": "909-525-0093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 JOHN R ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012013",
            "telephone_number": "800-527-6266",
            "fax_number": "313-576-8627"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "535 Barnhill Dr",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025116",
            "country_code": "US",
            "telephone_number": "909-525-0093",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAMDANI",
        "first_name": "HIRVA",
        "middle_name": "MANSURALI",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-06",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301098222",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MI",
            "license": "4301098222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.