NPIMap

Organization Active NPI

Cognitive Care Center PC

  • Psychologist
  • Novi, MI
National Provider Identifier
1649664467
Registry record updated Mar 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6301013794 Issued in MI
Legal business name
COGNITIVE CARE CENTER PC
Practice address
43155 Main St
Atrium 2300 Suite O
Novi, MI 48375-1777
Phone
(248) 330-7281
NPI assigned
Mar 19, 2015
Last updated
Mar 19, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2015

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

Authorized official

Name
Juvaria JavaidNPI 1851673537
Title
Msllp
Phone
(248) 330-7281

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6301013794 MI Primary

Addresses

Primary practice location

43155 Main St
Atrium 2300 Suite O
Novi, MI 48375-1777

Mailing address

43155 Main St
Atrium 2300 Suite O
Novi, MI 48375-1777

Other identifiers 1

IdentifierTypeStateIssuer
6301013794MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150424000249 MI Part B Supplier - Clinic/Group Practice 5890014898 Receives reassigned benefits from 9 practitioners
Practice locations: Novi, MI

National Provider Directory

National Provider Directory

Locations

24110 Meadowbrook Rd
Ste 105
Novi, MI 48375
Phone (734) 386-6527

43155 Main St
Ste 2300H
Novi, MI 48375
Phone (734) 386-6527

43155 Main St
Ste 2300O
Novi, MI 48375
Phone (248) 330-7281

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1426723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426723200000",
    "number": "1649664467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43155 MAIN ST",
            "address_2": "ATRIUM 2300 SUITE O",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43155 MAIN ST",
            "address_2": "ATRIUM 2300 SUITE O",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751777",
            "telephone_number": "248-330-7281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COGNITIVE CARE CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-19",
        "last_updated": "2015-03-19",
        "status": "A",
        "authorized_official_last_name": "JAVAID",
        "authorized_official_first_name": "JUVARIA",
        "authorized_official_title_or_position": "MSLLP",
        "authorized_official_telephone_number": "248-330-7281"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301013794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6301013794",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.