Poonam Patel, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301504732 Issued in MI

Practice address

21811 Kelly Rd
Eastpointe, MI 48021-2704

Phone

(586) 649-3388

Fax

(586) 842-3766

NPI assigned

Jul 10, 2017

Last updated

Dec 28, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Internal Medicine

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dedicated Physicians Group of Michigan, PLLCGroup PAC ID 1153735287, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ppatel1144038@direct.hfhs.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dedicated Physicians Group of Michigan, PLLC

  dba Dedicated Senior Medical Center

  • Internal Medicine Physician
  • Miami Gardens, FL
  • NPI 1992392393

  MI

  Medicare reassignment Care Compare group NPD
• Dedicated Physicians Group of Michigan PLLC

  dba Dedicated Senior Medical Center Eastpointe

  • Non-Pharmacy Dispensing Site
  • Eastpointe, MI
  • NPI 1730754656
  NPD
• Dedicated Physicians Group of Michigan PLLC

  dba Dedicated Senior Medical Center Detroit East

  • Non-Pharmacy Dispensing Site
  • Detroit, MI
  • NPI 1366028730
  NPD (past)

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

{
    "created_epoch": "1499644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1770005902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21811 KELLY RD",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480212704",
            "telephone_number": "586-649-3388",
            "fax_number": "586-842-3766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21811 KELLY RD",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480212704",
            "telephone_number": "586-649-3388",
            "fax_number": "586-842-3766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "POONAM",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-10",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301504732",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME157909",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haeri Park, DMD
• Janghoon Park
• Dale Parson Jr., PTA
• Brandi Pate-Brown
• Jitendrakumar Patel, PHARMACIST
• Charles Patterson
• Christian Patterson
• Paul E Marcuz D.D.S.,P.C.
• Pay Less Drugs Inc. (Pay Less Drugs)
• Pay Less RX LLC (Pay Less Rx)

• Internal Medicine Physician in Eastpointe, MI
• Providers in Eastpointe, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.