NPIMap

Individual provider Active NPI

Komal A Trivedi, M.D.

  • Internal Medicine Physician
  • Novi, MI
National Provider Identifier
1679736565
Registry record updated Nov 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301089840 Issued in MI
Practice address
26850 Providence Pkwy
Suite 505
Novi, MI 48374-1213
Phone
(248) 465-4163
Fax
(248) 662-4411
NPI assigned
Jul 9, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 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 4301089840 MI Primary

Addresses

Primary practice location

26850 Providence Pkwy
Suite 505
Novi, MI 48374-1213

Mailing address

26850 Providence Pkwy
Suite 505
Novi, MI 48374-1213
Phone (248) 465-4163

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110803000724 MI Practitioner - Internal Medicine 6800065178 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Health Providence HospitalGroup PAC ID 6103738703, 364 clinicians

Practice addresses (Care Compare)

24464 Thatcher Dr
Novi, MI 48375-2365
Phone (248) 302-0048

26850 Providence Pkwy
Novi, MI 48374-1213
Phone (248) 465-4500

Hospital & facility affiliations

  • Ascension Providence Hospital, Southfield and Novi Hospital, Southfield, MI, CCN 230019
  • Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053
  • Henry Ford Health St John Hospital Hospital, Detroit, MI, CCN 230165
  • Henry Ford Health West Bloomfield Hospital Hospital, W Bloomfield, MI, CCN 230302

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health Providence Hospital Current Accepting new patients
Henry Ford Health Providence Hospital CurrentSince Jan 1, 2016 Accepting new patients
Henry Ford Health Providence Hospital Internal Medicine CurrentSince Jan 1, 2016 Accepting new patients
Henry Ford Health Providence Hospital Past Accepting new patients

Locations

26850 Providence Pkwy
Ste 505
Novi, MI 48374
Phone (248) 465-4163

26850 Providence Pkwy
Novi, MI 48374
Phone (248) 380-3550

16001 W 9 Mile Rd
Southfield, MI 48075
Phone (248) 424-3000

28000 Dequindre Rd
Warren, MI 48092
Phone (586) 743-0944

Interoperability endpoints

  • Direct secure messaging: ktrivedi1155946@direct.hfhs.org
  • Direct secure messaging: komal.trivedi.1@22965.direct.athenahealth.com

Organizations & group practices 9

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 4

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": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447113600000",
    "number": "1679736565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26850 PROVIDENCE PKWY",
            "address_2": "SUITE 505",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483741213",
            "telephone_number": "248-465-4163",
            "fax_number": "248-662-4411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26850 PROVIDENCE PKWY",
            "address_2": "SUITE 505",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483741213",
            "telephone_number": "248-465-4163",
            "fax_number": "248-662-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIVEDI",
        "first_name": "KOMAL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-09",
        "last_updated": "2015-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301089840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

Verify at the official NPI Registry.