Individual provider Active NPI

Judith M. Edge, DO

  • Internal Medicine Physician
  • Dearborn Heights, MI
National Provider Identifier
1790771475
Registry record updated Nov 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5101009282 Issued in MI
Practice address
27015 W Warren St
Dearborn Heights, MI 48127-1901
Phone
(313) 278-1982
NPI assigned
Sep 27, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2023

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 5101009282 MI Primary

Addresses

Primary practice location

27015 W Warren St
Dearborn Heights, MI 48127-1901

Mailing address

26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849
Phone (947) 522-1862

Other practice location 1

8012 N Middlebelt Rd
Suite A
Westland, MI 48185-1808
Phone (734) 425-1225

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jedge96407@direct.beaumont.edu

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
I20100908000571 MI Practitioner - Internal Medicine 5193849586 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Michigan State University College of Osteopathic Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Oakwood Ambulatory LLCGroup PAC ID 1850282914, 271 clinicians

Practice addresses (Care Compare)

201 3Rd St
Suite 200
Belleville, MI 48111-2605
Phone (734) 697-9065

27015 W Warren St
Corewell Health Family Medicine
Dearborn Heights, MI 48127-1901
Phone (313) 278-1982

27031 W Warren St
Corewell Health Family Medicine
Dearborn Heights, MI 48127-1901
Phone (313) 274-3320

Hospital & facility affiliations

  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130
  • Beaumont Hospital - Dearborn Hospital, Dearborn, MI, CCN 230020
  • Corewell Health Wayne Hospital Hospital, Wayne, MI, CCN 230142
  • Beaumont Hospital - Farmington Hills Hospital, Farmington Hills, MI, CCN 230151
  • Beaumont Hospital - Taylor Hospital, Taylor, MI, CCN 230270

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101009282MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oakwood Ambulatory LLC Internal Medicine CurrentSince Nov 1, 2017 Accepting new patients
Oakwood Ambulatory, LLC CurrentSince Nov 1, 2017 Accepting new patients
Botsford General Hospital Past Accepting new patients

Locations

201 3rd St
Ste 200
Belleville, MI 48111
Phone (734) 697-9065

27015 W Warren St
Dearborn Heights, MI 48127
Phone (313) 278-1982

27031 W Warren St
Dearborn Heights, MI 48127
Phone (313) 274-3320

26901 Beaumont Blvd
Ste 3D
Southfield, MI 48033
Phone (947) 522-1860

Organizations & group practices 3

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 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700524800000",
    "number": "1790771475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849",
            "telephone_number": "947-522-1862",
            "fax_number": "947-522-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27015 W WARREN ST",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481271901",
            "telephone_number": "313-278-1982"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8012 N Middlebelt Rd",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "Westland",
            "state": "MI",
            "postal_code": "481851808",
            "country_code": "US",
            "telephone_number": "734-425-1225",
            "fax_number": "734-261-0284",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDGE",
        "first_name": "JUDITH",
        "middle_name": "M.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-27",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101009282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jedge96407@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "27015 W Warren St",
            "city": "Dearborn Heights",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481271901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dearborn Heights, MI

Sources for this page

Verify at the official NPI Registry.