Individual provider Active NPI

Tassia Zoma Pfefferkorn, M.D.

  • Internal Medicine Physician
  • Novi, MI
National Provider Identifier
1467716514
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301100187 Issued in MI
Practice address
46325 W 12 Mile Rd Ste 390
Novi, MI 48377-2464
Phone
(248) 719-7271
Fax
(248) 719-7245
NPI assigned
Jul 3, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

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 4301100187 MI Primary

Addresses

Primary practice location

46325 W 12 Mile Rd Ste 390
Novi, MI 48377-2464

Mailing address

46325 W 12 Mile Rd Ste 390
Novi, MI 48377-2464
Phone (248) 719-7271

Other identifiers 1

IdentifierTypeStateIssuer
4301100187OtherMILARA MICHIGAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105-9484

2520 S Telegraph Rd
Suite 101
Bloomfield Hills, MI 48302-0202

44428 Woodward Ave
Suite 101
Pontiac, MI 48341-5009

6825 Allen Rd
Allen Park, MI 48101-2007

PO Box
Suite 3272
Saginaw, MI 48605-3272

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301100187MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Ooma Primary LLC Internal Medicine CurrentSince Jun 1, 2021 Accepting new patients
Iha Ooma Primary LLC Internal Medicine CurrentSince Jun 1, 2021 Accepting new patients

Locations

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

43097 Woodward Ave
Ste 204
Bloomfield Township, MI 48302
Phone (248) 334-3136

1375 S Lapeer Rd
Ste 210
Lake Orion, MI 48360
Phone (248) 693-5700

Organizations & group practices 2

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 5

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": "1341273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1467716514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46325 W 12 MILE RD STE 390",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483772464",
            "telephone_number": "248-719-7271",
            "fax_number": "248-719-7245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46325 W 12 MILE RD STE 390",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483772464",
            "telephone_number": "248-719-7271",
            "fax_number": "248-719-7245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFEFFERKORN",
        "first_name": "TASSIA",
        "middle_name": "ZOMA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-03",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301100187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LARA MICHIGAN",
            "identifier": "4301100187",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.