Individual provider Active NPI

Jagatbhai A Amin, M.D.

  • Internal Medicine Physician
  • Clinton TWP, MI
National Provider Identifier
1730220757
Registry record updated Apr 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301035463 Issued in MI
Practice address
43171 Dalcoma Dr
Ste 11
Clinton TWP, MI 48038-6307
Phone
(586) 792-5300
Fax
(586) 792-5930
NPI assigned
Feb 11, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301035463 MI Primary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 4301035463 MI

Addresses

Primary practice location

43171 Dalcoma Dr
Ste 11
Clinton TWP, MI 48038-6307

Mailing address

43171 Dalcoma Dr
Ste 11
Clinton TWP, MI 48038-6307
Phone (586) 792-5300

Other identifiers 1

IdentifierTypeStateIssuer
2105075MedicaidMI

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
I20110930000040 MI Practitioner - Internal MedicinePractitioner - Endocrinology 2365614054 Practice locations: Clinton TWP, MI

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: jamin63205@direct.hfhs.org

NPI Registry JSON

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

{
    "created_epoch": "1171152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649980800000",
    "number": "1730220757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43171 DALCOMA DR",
            "address_2": "STE 11",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480386307",
            "telephone_number": "586-792-5300",
            "fax_number": "586-792-5930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43171 DALCOMA DR",
            "address_2": "STE 11",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480386307",
            "telephone_number": "586-792-5300",
            "fax_number": "586-792-5930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMIN",
        "first_name": "JAGATBHAI",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-11",
        "last_updated": "2022-04-15",
        "certification_date": "2022-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301035463",
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MI",
            "license": "4301035463",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2105075",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton TWP, MI

Sources for this page

Verify at the official NPI Registry.