Individual provider Active NPI

Jayesh Prakash Thawani, MD

  • Neurological Surgery Physician
  • Ypsilanti, MI
National Provider Identifier
1851611750
Registry record updated Aug 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
4301115469 Issued in MI
Practice address
5315 Elliott Dr Ste 102
Ypsilanti, MI 48197
Phone
(734) 712-4500
NPI assigned
Jun 3, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 4301115469 MI Primary

Addresses

Primary practice location

5315 Elliott Dr Ste 102
Ypsilanti, MI 48197

Mailing address

3400 Spruce St
Philadelphia, PA 19104-4206
Phone (215) 662-3487

Other practice location 1

3400 Spruce St
Philadelphia, PA 19104-4206
Phone (215) 662-3487

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
I20180625000402 MI Practitioner - Neurosurgery 8628334356 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
University of Michigan Medical School, 2010
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)

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

5315 Elliott Dr
Ypsilanti, MI 48197-8634

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion176
Laminectomy or laminotomy (partial removal of spine bones)50

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301115469MIMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Health Services Corporation Neurological Surgery CurrentSince May 1, 2022 Accepting new patients
Iha Health Service Corporation CurrentSince May 1, 2022 Accepting new patients
Iha Health Services Corporation Current Accepting new patients
Iha Health Services Corporation Past Accepting new patients

Locations

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

2305 Genoa Business Park Dr
Ste 200
Brighton, MI 48114
Phone (810) 494-6840

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

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

5315 Elliott Dr
Ste 102
Ypsilanti, MI 48197
Phone (313) 434-4110

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1275523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564704000000",
    "number": "1851611750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044206",
            "telephone_number": "215-662-3487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5315 ELLIOTT DR STE 102",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "48197",
            "telephone_number": "734-712-4500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3400 Spruce St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191044206",
            "country_code": "US",
            "telephone_number": "215-662-3487",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THAWANI",
        "first_name": "JAYESH",
        "middle_name": "PRAKASH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-03",
        "last_updated": "2019-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MI",
            "license": "4301115469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.