Individual provider Active NPI

Crystal Thamer Ajja, DO

  • Internal Medicine Physician
  • Rochester Hills, MI
National Provider Identifier
1447814694
Registry record updated Feb 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5101027482 Issued in MI
Practice address
1701 South Blvd E Ste 250
Rochester Hills, MI 48307-6123
Phone
(248) 293-1002
NPI assigned
Apr 23, 2019
Last updated
Feb 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2024

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 5101027482 MI Primary

Addresses

Primary practice location

1701 South Blvd E Ste 250
Rochester Hills, MI 48307-6123

Mailing address

1701 South Blvd E Ste 250
Rochester Hills, MI 48307-6123
Phone (248) 293-1002

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
I20230918001413 MI Practitioner - Internal MedicinePractitioner - Pediatric Medicine 8921331877 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Michigan State University College of Osteopathic Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Arcturus Healthcare PLCGroup PAC ID 7012143118, 63 clinicians
Powerback Rehabilitation LLCGroup PAC ID 2365359932, shared by 106 NPIs, 600 clinicians

Practice addresses (Care Compare)

1701 S Blvd E
Rochester Hills, MI 48307-6116

44003 Partridge Creek Blvd
Clinton TWP, MI 48038-0002
Phone (342) 627-3267

4600 Investment Dr
Troy, MI 48098-6368
Phone 24826750003025

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Arcturus Healthcare PLC Internal Medicine CurrentSince Nov 6, 2023 Accepting new patients
Arcturus Healthcare PLC Internal Medicine CurrentSince Nov 6, 2023 Accepting new patients
Macomb Oakland Adult Medicine PC Internal Medicine Current Accepting new patients

Locations

1701 South Blvd E
Ste 250
Rochester Hills, MI 48307
Phone (248) 293-1002

1701 South Blvd E
Ste 290
Rochester Hills, MI 48307
Phone (248) 997-7000

Interoperability endpoints

  • Direct secure messaging: crystalajja@pmg.allscriptsdirect.net

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": "1555977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707523200000",
    "number": "1447814694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 SOUTH BLVD E STE 250",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483076123",
            "telephone_number": "248-293-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 SOUTH BLVD E STE 250",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483076123",
            "telephone_number": "248-293-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AJJA",
        "first_name": "CRYSTAL",
        "middle_name": "THAMER",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-23",
        "last_updated": "2024-02-10",
        "certification_date": "2024-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101027482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester Hills, MI

Sources for this page

Verify at the official NPI Registry.