Individual provider Active NPI

Justine Auxilia Irene Chinnappan

  • Hematology & Oncology Physician
  • Southfield, MI
National Provider Identifier
1861074460
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
4301514206 Issued in MI
Practice address
22301 Foster Winter Dr
Southfield, MI 48075-3707
Phone
(248) 849-3541
Fax
(248) 849-2899
NPI assigned
Apr 22, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2025

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 35.151234 OH
Hematology & Oncology Physician 207RH0003X 4301514206 MI Primary

Addresses

Primary practice location

22301 Foster Winter Dr
Southfield, MI 48075-3707

Mailing address

22301 Foster Winter Dr
Southfield, MI 48075-3707
Phone (248) 849-3541

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20240909001818 OH Practitioner - Internal Medicine 8426598186 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4301514206MIMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usacs Integrated Acute Care Services of Ohio, LLC Internal Medicine CurrentSince Jul 6, 2024 Accepting new patients
Jewish Hospital LLC Past Accepting new patients

Locations

100 Medical Center Dr
Springfield, OH 45504
Phone (937) 523-1000

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1619049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1861074460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22301 FOSTER WINTER DR",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753707",
            "telephone_number": "248-849-3541",
            "fax_number": "248-849-2899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22301 FOSTER WINTER DR",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753707",
            "telephone_number": "248-849-3541",
            "fax_number": "248-849-2899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHINNAPPAN",
        "first_name": "JUSTINE AUXILIA",
        "middle_name": "IRENE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-22",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.151234",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MI",
            "license": "4301514206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.