John Bajouka

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

5151016623 Issued in MI

Practice address

22250 Providence Dr Ste 301
Southfield, MI 48075-6211

Phone

(248) 849-3281

NPI assigned

Mar 26, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1711411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1881444370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2370 E HAMMOND LAKE DR",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483020133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22250 PROVIDENCE DR STE 301",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480756211",
            "telephone_number": "248-849-3281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAJOUKA",
        "first_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-26",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5151016623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carly Bagwell
• Jasmine Bahm
• Mark Marlin Bahoura, M.D.
• Cara Bailey, LMSW, LCSW
• Melanie Elizabeth Baird, LMSW
• Sharon Bajwa, M.D.
• Onajomo Violet Bakare, NP
• Beth Lanette Baker Callen, LMSW
• David A Baker, MSW
• Delores Faye Baker, MD

• Internal Medicine Physician in Southfield, MI
• Providers in Southfield, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.