Individual provider Active NPI

Danyielle Krista Jernukian, AGPCNP-BC

  • Primary Care Nurse Practitioner
  • Southfield, MI
National Provider Identifier
1861097263
Registry record updated Dec 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
4704317172 Issued in MI
Practice address
25130 Southfield Rd
Southfield, MI 48075-1910
Phone
(248) 234-6799
NPI assigned
Dec 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 4704317172 MI Primary

Addresses

Primary practice location

25130 Southfield Rd
Southfield, MI 48075-1910

Mailing address

44307 Princeton Dr
Clinton Township, MI 48038-1095

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240417003785 OH Practitioner - Nurse Practitioner 0446662431 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Oakland Univ, William Beaumont School of Medicine, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

44307 Princeton Dr
Clinton Township, MI 48038-1095

Merit-based Incentive Payment System (MIPS)

Final score
91.21 of 100Reported as group
Quality
88.24
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704317172MIMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Id Consultants Inc CurrentSince Aug 1, 2024 Accepting new patients
Infusion Associates PLLC CurrentSince Jun 1, 2022 Accepting new patients
Infusion Associates of Ohio LLC CurrentSince Mar 14, 2024 Accepting new patients
Id Consultants of Northeast Ohio, Inc PastSince Sep 1, 2021 Accepting new patients
Little People Urgent Care PLC PastSince Mar 1, 2016 Accepting new patients

Locations

3270 Washtenaw Ave
Ann Arbor, MI 48104

250 W Eisenhower Pkwy
Ste 130
Ann Arbor, MI 48103

43650 Garfield Rd
Ste 104
Clinton Township, MI 48038
Phone (313) 756-7990

44720 Hayes Rd
Ste 200
Clinton Township, MI 48038

830 W Lake Lansing Rd
Ste 150
East Lansing, MI 48823
Phone (517) 897-9200

830 W Lake Lansing Rd
East Lansing, MI 48823
Phone (517) 333-3777

1600 S Beacon Blvd
Grand Haven, MI 49417
Phone (614) 954-0600

1600 S Beacon Blvd
Ste 100
Grand Haven, MI 49417
Phone (614) 954-0600

3230 Eagle Park Dr NE
Ste 101
Grand Rapids, MI 49525

4343 Chicago Dr SW
Grandville, MI 49418

39475 Lewis Dr
Ste 140
Novi, MI 48377
Phone (248) 489-0766

1399 W Centre Ave
Portage, MI 49024
Phone (269) 615-1657

363 W Big Beaver Rd
Ste 126
Troy, MI 48084
Phone (248) 220-5230

363 W Big Beaver Rd
Ste 125
Troy, MI 48084

3401 Enterprise Pkwy
Ste 110
Beachwood, OH 44122
Phone (216) 245-6762

6640 Poe Ave
Ste 110
Dayton, OH 45414
Phone (937) 759-9906

150 Springside Dr
Ste 235B
Fairlawn, OH 44333
Phone (216) 360-9480

155 Lincoln Way W
Ste A109
Massillon, OH 44647
Phone (216) 488-1060

9381 Mentor Ave
Mentor, OH 44060
Phone (440) 890-4736

18100 Jefferson Park Rd
Ste 106
Middleburg Heights, OH 44130
Phone (216) 628-7050

50 Normandy Dr
Ste 1
Painesville, OH 44077

6220 Wilmington Pike
Ste 6220B
Sugarcreek Township, OH 45459
Phone (937) 741-4658

2000 Regency Ct
Ste 100A
Toledo, OH 43623
Phone (833) 394-0600

2211 Crocker Rd
Ste 170
Westlake, OH 44145
Phone (216) 360-9480

1111 Boardman Canfield Rd
Youngstown, OH 44512
Phone (330) 965-0909

Interoperability endpoints

  • Direct secure messaging: djernukian301409@direct.hfhs.org

Organizations & group practices 5

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": "1606867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1861097263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44307 PRINCETON DR",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25130 SOUTHFIELD RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480751910",
            "telephone_number": "248-234-6799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERNUKIAN",
        "first_name": "DANYIELLE",
        "middle_name": "KRISTA",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-02",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "4704317172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.