Individual provider Active NPI

Agnieszka Dagmara Choromanska, M.D.

  • Diagnostic Radiology Physician
  • Royal Oak, MI
National Provider Identifier
1447511811
Registry record updated Jul 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
4301100556 Issued in MI
Practice address
3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone
(248) 898-6091
Fax
(248) 898-2496
NPI assigned
Jun 1, 2012
Last updated
Jul 1, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 4301100556 MI Primary

Addresses

Primary practice location

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712

Mailing address

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone (248) 898-6091

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
I20160630000032 MI Practitioner - Diagnostic Radiology 5991007031 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren Medical GroupGroup PAC ID 3971416082, 240 clinicians

Practice addresses (Care Compare)

32901 23 Mile Rd
Suite 120
Chesterfield, MI 48047-4032
Phone (586) 725-4604

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

416 Connable Ave
Petoskey, MI 49770-2212
Phone (517) 975-6475

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301100556MIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Medical Group Diagnostic Radiology CurrentSince Mar 19, 2024 Accepting new patients
Barbara Ann Karmanos Cancer Institute CurrentSince Oct 1, 2017 Accepting new patients
Barbara Ann Karmanos Cancer Institute CurrentSince Oct 1, 2017 Accepting new patients
McLaren Medical Group CurrentSince Mar 19, 2024 Accepting new patients

Locations

32901 23 Mile Rd
Ste 120
Chesterfield, MI 48047
Phone (586) 725-4604

39373 Garfield Rd
Clinton Twp, MI 48038
Phone (586) 286-4880

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 4

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 6

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": "1338508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467331200000",
    "number": "1447511811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 W 13 MILE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736712",
            "telephone_number": "248-898-6091",
            "fax_number": "248-898-2496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 W 13 MILE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736712",
            "telephone_number": "248-898-6091",
            "fax_number": "248-898-2496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOROMANSKA",
        "first_name": "AGNIESZKA",
        "middle_name": "DAGMARA",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-01",
        "last_updated": "2016-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301100556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.