Organization Active NPI

Roger D Ajluni MD PC

  • Primary Care Clinic/Center
  • Livonia, MI
National Provider Identifier
1669619748
Registry record updated Jan 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
4301082209 Issued in MI
Legal business name
ROGER D AJLUNI MD PC
Practice address
17920 Farmington Rd
Livonia, MI 48152-3104
Phone
(734) 425-5200
Fax
(734) 425-7755
NPI assigned
Jan 12, 2009
Last updated
Jan 12, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2009

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

Authorized official

Name
Dr. Roger David Ajluni Jr., M.D.NPI 1760439145
Title
Owner
Phone
(734) 425-5200

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
Primary Care Clinic/Center 261QP2300X 4301082209 MI Primary

Addresses

Primary practice location

17920 Farmington Rd
Livonia, MI 48152-3104

Mailing address

17920 Farmington Rd
Livonia, MI 48152-3104
Phone (734) 425-5200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090224000557 MI Part B Supplier - Clinic/Group Practice 5193880243 Receives reassigned benefits from 1 practitioner
Practice locations: Livonia, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D0875443Roger D Ajluni MD PC17920 Farmington Road, Livonia, MI 48152Certificate of waiverMay 31, 2028

National Provider Directory

National Provider Directory

Locations

17920 Farmington Rd
Livonia, MI 48152
Phone (734) 425-5200

Practitioners & affiliated clinicians

Practitioners 1

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": "1231718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231718400000",
    "number": "1669619748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17920 FARMINGTON RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481523104",
            "telephone_number": "734-425-5200",
            "fax_number": "734-425-7755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17920 FARMINGTON RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481523104",
            "telephone_number": "734-425-5200",
            "fax_number": "734-425-7755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROGER D AJLUNI MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-12",
        "last_updated": "2009-01-12",
        "status": "A",
        "authorized_official_last_name": "AJLUNI",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-425-5200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MI",
            "license": "4301082209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.