MST Jannatul Mawa Chowdhury, PA-C
Individual provider Active NPI Physician Assistant · Hamtramck, MI
NPI 1619726031 · NPPES record last updated Sep 10, 2024
Key facts
- NPI
- 1619726031
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 5601012292 (MI)
- Practice address
- 11828 Joseph Campau St
Hamtramck, MI 48212-3049 - Phone
- (313) 707-0122
- NPI assigned
- May 16, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Metro Medical Center PLLC
Practice addresses (Care Compare)
11828 Joseph Campau St
Hamtramck, MI 48212-3049
Phone (586) 276-7436
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240911001795 | MI | Practitioner - Physician Assistant | 7315487816 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601012292 | MI | Yes |
Addresses
Primary practice location
11828 Joseph Campau St
Hamtramck, MI 48212-3049
Mailing address
26322 Buster Dr
Warren, MI 48091-3926
Phone (586) 738-7062
Other providers in Hamtramck, MI
- Center for New Life
- Charter County of Wayne
- Children First Pediatric Care PLLC
- Childrens Clinic of Michigan PLLC
- Tanbir Karim Choudhury
- Soneya Akther Chowdhury
- City of Hamtramck
- Cynthia Cohen
- Colonial Health Care Center,LLC Dba St. Josephs'S Health Care Center
- Colonial Healthcare Center LLC
All providers in Hamtramck, MI · Physician Assistant in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.