Individual provider Active NPI

Emilyn Rose Anderi, MD

  • Family Medicine Physician
  • Detroit, MI
National Provider Identifier
1457933731
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301511471 Issued in MI
Practice address
2799 W Grand Blvd
Detroit, MI 48202
Phone
(313) 656-1600
Fax
(313) 656-1610
NPI assigned
Apr 26, 2021
Last updated
Jun 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X 1457933731 MI
Family Medicine Physician 207Q00000X 4301511471 MI Primary

Addresses

Primary practice location

2799 W Grand Blvd
Detroit, MI 48202

Mailing address

2799 W Grand Blvd
CFP 046
Detroit, MI 48202
Phone (313) 916-1601

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
I20240618002315 MI Practitioner - Family Practice 6002204484 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wayne State University School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

3370 E Jefferson Ave
Detroit, MI 48207-4236
Phone (313) 656-1600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1457933731MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Current Accepting new patients
Henry Ford Pathology Current Accepting new patients
Henry Ford Health System CurrentSince Jun 11, 2024 Accepting new patients
Henr Y Ford Health System Family Medicine CurrentSince Jun 11, 2024 Accepting new patients
Henry Ford Maplegrove Center Past Accepting new patients

Locations

1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-2892

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

2799 W Grand Blvd
#46
Detroit, MI 48202
Phone (313) 916-1601

3370 E Jefferson Ave
Detroit, MI 48207
Phone (313) 656-1600

Interoperability endpoints

  • Direct secure messaging: eanderi724218@direct.hfhs.org

Organizations & group practices 5

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 1

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": "1619395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1457933731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "address_2": "CFP 046",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48202",
            "telephone_number": "313-916-1601",
            "fax_number": "313-916-2018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48202",
            "telephone_number": "313-656-1600",
            "fax_number": "313-656-1610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERI",
        "first_name": "EMILYN",
        "middle_name": "ROSE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-26",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "1457933731",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301511471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.