Individual provider Active NPI

Yasmin Keshavjee, M.D.

  • Addiction Medicine (Family Medicine) Physician
  • Warren, MI
National Provider Identifier
1477920510
Registry record updated Dec 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
License
4301068882 Issued in MI
Practice address
28800 Ryan Rd
Suite 320
Warren, MI 48092-4272
Phone
(586) 582-0500
NPI assigned
Aug 24, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) Physician 207QA0401X 4301068882 MI Primary

Addresses

Primary practice location

28800 Ryan Rd
Suite 320
Warren, MI 48092-4272

Mailing address

400 Stoddard Rd
Richmond, MI 48062-2505
Phone (586) 582-0500

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
I20151015001291 MI Practitioner - Addiction MedicinePractitioner - Family Practice 1153630058 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Rehabilitation Center, Inc. CurrentSince Nov 11, 2018 Accepting new patients
Sacred Heart Rehabilitation Center, Inc CurrentSince Aug 1, 2021 Accepting new patients
Sacred Heart Rehabilitation Center, Inc Past Accepting new patients

Locations

1400 E 12 Mile Rd
Madison Hts, MI 48071
Phone (248) 547-2223

400 Stoddard Rd
Richmond, MI 48062

19611 E 8 Mile Rd
St Clr Shores, MI 48080
Phone (586) 541-9550

Interoperability endpoints

  • Direct secure messaging: yasminkeshavjee@ipsychiatry.direct.kno2fy.com

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1440374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544486400000",
    "number": "1477920510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 STODDARD RD",
            "city": "RICHMOND",
            "state": "MI",
            "postal_code": "480622505",
            "telephone_number": "586-582-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28800 RYAN RD",
            "address_2": "SUITE 320",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480924272",
            "telephone_number": "586-582-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESHAVJEE",
        "first_name": "YASMIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-24",
        "last_updated": "2018-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "MI",
            "license": "4301068882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.