Individual provider Active NPI

Renee R Jiddou-Yaldoo, MD

  • Infectious Disease Physician
  • Warren, MI
National Provider Identifier
1568662203
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
4301090609 Issued in MI
Practice address
27070 Hoover Rd
Beaumont Associated Family Care Physicians
Warren, MI 48093-4590
Phone
(586) 427-7300
NPI assigned
Jul 20, 2007
Last updated
Oct 21, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301090609 MI
Infectious Disease Physician 207RI0200X 4301090609 MI Primary

Addresses

Primary practice location

27070 Hoover Rd
Beaumont Associated Family Care Physicians
Warren, MI 48093-4590

Mailing address

130 Town Center Dr Ste 203
Beaumont Provider Enrollment
Troy, MI 48084-1744

Other names 1

  • Renee R Jiddou Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rjiddou19803@direct.beaumont.edu

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
I20100714000983 MI Practitioner - Infectious DiseasePractitioner - Internal Medicine 1153453998 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beaumont Medical Group Hospital Based ServicesGroup PAC ID 3072875889, 575 clinicians

Practice addresses (Care Compare)

25631 Little Mack Ave
Suite 205
Saint Clair Shores, MI 48081-2108
Phone (586) 443-2930

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

3601 W 13 Mile Rd Ec
Beaumont Emergency Services Ro
Royal Oak, MI 48073-6712
Phone (248) 898-0575

44201 Dequindre Rd
Troy, MI 48085-1117
Phone (248) 964-1187

44201 Dequindre Rd Ec
Beaumont Emergency Services TR
Troy, MI 48085-1117
Phone (248) 964-5111

468 Cadieux Rd
Grosse Pointe, MI 48230-1507
Phone (313) 473-1605

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.64 of 100Reported as group
Quality
85.06
Promoting interoperability
100
Improvement activities
40
Cost
77.9

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301090609MIMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beaumont Medical Group Hospital -Based Services CurrentSince Feb 13, 2018 Accepting new patients
William Beaumont Hospital Past Accepting new patients

Locations

3601 W 13 Mile Rd
Royal Oak, MI 48073

44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255

Interoperability endpoints

  • Direct secure messaging: rjiddou19803@direct.beaumont.edu
  • Direct secure messaging: rjiddouyaldoo1239913@epic00.shdirect.org

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, 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": "1184889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1568662203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 TOWN CENTER DR STE 203",
            "address_2": "BEAUMONT PROVIDER ENROLLMENT",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480841744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27070 HOOVER RD",
            "address_2": "BEAUMONT ASSOCIATED FAMILY CARE PHYSICIANS",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480934590",
            "telephone_number": "586-427-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIDDOU-YALDOO",
        "first_name": "RENEE",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-20",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301090609",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MI",
            "license": "4301090609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rjiddou19803@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "27070 Hoover Rd",
            "address_2": "Beaumont Associated Family Care Physicians",
            "city": "Warren",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480934590",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "RENEE",
            "last_name": "JIDDOU",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.