Active NPI
Syifa Rahmadianputri Djunaedi, DO
- Student in an Organized Health Care Education/Training Program
- Flint, MI
National Provider Identifier
1598495277
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 5151017557
- Practice address
- 401 S Ballenger Hwy
Flint, MI 48532-3638 - Phone
- (810) 342-2000
- Fax
- (810) 342-3659
- NPI assigned
- Jun 15, 2022
- Last updated
- Jun 18, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 5151017557 | MI | Primary |
Addresses
Primary practice location
401 S Ballenger Hwy
Flint, MI 48532-3638
Mailing address
401 S Ballenger Hwy
Flint, MI 48532-3638
Phone (810) 342-2000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5151017557 | MI | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750204800000",
"number": "1598495277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 S BALLENGER HWY",
"city": "FLINT",
"state": "MI",
"postal_code": "485323638",
"telephone_number": "810-342-2000",
"fax_number": "810-342-3659"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 S BALLENGER HWY",
"city": "FLINT",
"state": "MI",
"postal_code": "485323638",
"telephone_number": "810-342-2000",
"fax_number": "810-342-3659"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DJUNAEDI",
"first_name": "SYIFA",
"middle_name": "RAHMADIANPUTRI",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-15",
"last_updated": "2025-06-18",
"certification_date": "2025-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MI",
"license": "5151017557",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flint, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.