Individual provider Active NPI

Cristina Tita, M.D.

  • Advanced Heart Failure and Transplant Cardiology Physician
  • Jackson, MI
National Provider Identifier
1861605362
Registry record updated Jun 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Heart Failure and Transplant Cardiology PhysicianTaxonomy code 207RA0001X
License
4301082141 Issued in MI
Practice address
1100 E Michigan Ave Ste 100
Jackson, MI 49201-1800
Phone
(517) 205-3345
NPI assigned
May 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301082141 MI
Cardiovascular Disease Physician 207RC0000X 4301082141 MI
Advanced Heart Failure and Transplant Cardiology Physician 207RA0001X 4301082141 MI Primary

Addresses

Primary practice location

1100 E Michigan Ave Ste 100
Jackson, MI 49201-1800

Mailing address

2799 W Grand Blvd
Dept of Cardiology
Detroit, MI 48202-2608
Phone (313) 916-2966

Other practice location 1

2799 W Grand Blvd
Dept of Cardiology
Detroit, MI 48202-2608
Phone (313) 916-2966

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
I20070806000255 MI Practitioner - Advanced Heart Failure and Transplant CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 4789775768 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Advanced Heart Failure and Transplant CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301082141MIMDAdvanced Heart Failure and Transplant Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Advanced Heart Failure and Transplant Cardiology CurrentSince Jul 1, 2007 Accepting new patients
Henry Ford Health System Current Accepting new patients
Henry Ford Health System CurrentSince Jul 1, 2007 Accepting new patients
Wa Foote Memorial Hospital, Inc Current Accepting new patients
W.a. Foote Memorial Hospital, Inc Cardiovascular Disease CurrentSince Jun 22, 2020 Accepting new patients
Henry Ford Maplegrove Center Past Accepting new patients

Locations

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

2799 W Grand Blvd
#K14
Detroit, MI 48202
Phone (313) 916-2695

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

2799 W Grand Blvd
#5
Detroit, MI 48202
Phone (313) 916-2710

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

1100 E Michigan Ave
Ste 100
Jackson, MI 49201
Phone (517) 205-3345

Interoperability endpoints

  • Direct secure messaging: ctita5462@direct.hfhs.org

Organizations & group practices 6

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 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": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592784000000",
    "number": "1861605362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "address_2": "DEPT OF CARDIOLOGY",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "313-916-2966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E MICHIGAN AVE STE 100",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011800",
            "telephone_number": "517-205-3345"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2799 W Grand Blvd",
            "address_2": "Dept of Cardiology",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482022608",
            "country_code": "US",
            "telephone_number": "313-916-2966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TITA",
        "first_name": "CRISTINA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-08",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301082141",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301082141",
            "primary": false
        },
        {
            "code": "207RA0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Advanced Heart Failure and Transplant Cardiology",
            "state": "MI",
            "license": "4301082141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.