Individual provider Active NPI

Cassie Tominna Konja, D.O.

  • Internal Medicine Physician
  • Warren, MI
National Provider Identifier
1629204797
Registry record updated Aug 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5101018206 Issued in MI
Practice address
12000 E 12 Mile Rd
Warren, MI 48093-3570
Phone
(586) 576-4140
Fax
(586) 576-4146
NPI assigned
Jun 3, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2015

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 5101018206 MI Primary

Addresses

Primary practice location

12000 E 12 Mile Rd
Warren, MI 48093-3570

Mailing address

4967 Crooks Rd
Ste 130
Troy, MI 48098-5801
Phone (248) 952-1601

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
I20140110001376 MI Practitioner - Internal Medicine 8729216163 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11800 E 12 Mile Rd
Ascension Macomb Oakland Hospital
Warren, MI 48093-3472
Phone (586) 573-5000

27483 Dequindre Rd
Suite 204
Madison Heights, MI 48071-5711
Phone (248) 967-7326

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101018206MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health Macomb-Oakland Hospital Internal Medicine CurrentSince Jan 14, 2021 Accepting new patients
Henry Ford Health Macomb-Oakland Hospital CurrentSince Jan 14, 2021 Accepting new patients
Inpatient Consultants of Michigan PC Internal Medicine CurrentSince Oct 25, 2013 Accepting new patients
Henry Ford Health Macomb Oakland Hospital Past Accepting new patients

Locations

22600 W Main St
Armada, MI 48005
Phone (734) 508-4569

1014 E Grand River Ave
Brighton, MI 48116
Phone (810) 220-5222

15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2300

1 William Carls Dr
Commerce Twp, MI 48382
Phone (248) 227-5500

27483 Dequindre Rd
Ste 204
Madison Hts, MI 48071
Phone (248) 967-7326

27351 Dequindre Rd
Madison Hts, MI 48071
Phone (248) 967-7000

4967 Crooks Rd
Ste 130
Troy, MI 48098
Phone (248) 952-1601

12000 E 12 Mile Rd
Warren, MI 48093
Phone (586) 573-5000

625 36th St SW
Wyoming, MI 49509
Phone (517) 481-3715

Interoperability endpoints

  • Direct secure messaging: ckonja1135048@direct.hfhs.org

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.

Hospital & facility affiliations 2

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": "1243987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440633600000",
    "number": "1629204797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4967 CROOKS RD",
            "address_2": "STE 130",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480985801",
            "telephone_number": "248-952-1601",
            "fax_number": "248-952-1614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12000 E 12 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933570",
            "telephone_number": "586-576-4140",
            "fax_number": "586-576-4146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONJA",
        "first_name": "CASSIE",
        "middle_name": "TOMINNA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-03",
        "last_updated": "2015-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101018206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.