Individual provider Active NPI

Jerome D Winegarden, MD

  • Medical Oncology Physician
  • Ypsilanti, MI
National Provider Identifier
1811982689
Registry record updated Dec 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
4301081828 Issued in MI
Practice address
5303 Elliott Dr.
Suite 210
Ypsilanti, MI 48197
Phone
(734) 712-1000
Fax
(734) 712-1012
NPI assigned
Sep 16, 2005
Last updated
Dec 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 081828 MI
Medical Oncology Physician 207RX0202X 4301081828 MI Primary

Addresses

Primary practice location

5303 Elliott Dr.
Suite 210
Ypsilanti, MI 48197

Mailing address

24 Frank Lloyd Wright Drive
Suite J2000
Ann Arbor, MI 48105
Phone (734) 747-6766

Other identifiers 1

IdentifierTypeStateIssuer
4611112MedicaidMI

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
I20040217000725 MI Practitioner - Hematology/OncologyPractitioner - Medical Oncology 7416842612 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Wayne State University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

1600 S Canton Ctr Rd
Canton, MI 48188-1992

44428 Woodward Ave
Suite 102
Pontiac, MI 48341-5009
Phone (734) 712-8700

51341 W Huron River Dr
Trinity Health Iha Medical Group Primary Ca
Van Buren Township, MI 48111-2571
Phone (734) 997-0304

5301 E Huron River Dr
Ypsilanti, MI 48197-1051

5301 McAuley Dr
Ypsilanti, MI 48197-1051

5303 Elliott Dr
Suite 202
Ypsilanti, MI 48197-8632
Phone (734) 712-2005

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
081828MIMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Health Services Corporation Current Accepting new patients
Iha Health Services Corporation Hematology & Oncology CurrentSince Jul 15, 2011 Accepting new patients
Iha Health Service Corporation CurrentSince Jul 15, 2011 Accepting new patients
Ann Arbor Hematology Oncology Associates PC Hematology & Oncology Past Accepting new patients

Locations

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

7575 Grand River Rd
Brighton, MI 48114
Phone (810) 844-7544

7575 Grand River Rd
Ste 202
Brighton, MI 48114
Phone (810) 844-7566

7575 Grand River Rd
Ste 208
Brighton, MI 48114
Phone (810) 844-7740

1600 S Canton Center Rd
Canton, MI 48188
Phone (734) 398-7557

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

775 S Main St
Chelsea, MI 48118
Phone (313) 995-3764

44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700

5301 McAuley Dr
Ypsilanti, MI 48197
Phone (734) 712-7246

5303 Elliott Dr
Ste 210
Ypsilanti, MI 48197
Phone (734) 712-1000

5361 McAuley Dr
Ypsilanti, MI 48197
Phone (734) 712-1300

Organizations & group practices 4

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.

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": "1126828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1811982689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DRIVE",
            "address_2": "SUITE J2000",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48105",
            "telephone_number": "734-747-6766",
            "fax_number": "734-222-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5303 ELLIOTT DR.",
            "address_2": "SUITE 210",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "48197",
            "telephone_number": "734-712-1000",
            "fax_number": "734-712-1012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINEGARDEN",
        "first_name": "JEROME",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-16",
        "last_updated": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MI",
            "license": "081828",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "MI",
            "license": "4301081828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4611112",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.