Individual provider Active NPI

Sandra A Jones, MD

  • Internal Medicine Physician
  • Southfield, MI
National Provider Identifier
1902862667
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301051935 Issued in MI
Practice address
26677 W 12 Mile Rd # B6
Southfield, MI 48034-1514
Phone
(248) 354-4709
Fax
(248) 354-4807
NPI assigned
Apr 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301051935 MI Primary

Addresses

Primary practice location

26677 W 12 Mile Rd # B6
Southfield, MI 48034-1514

Mailing address

PO Box 674147
Detroit, MI 48267-4147
Phone (248) 354-4709

Other practice location 1

28411 Northwestern Hwy
Suite 1050
Southfield, MI 48034-5544
Phone (248) 354-4709

Other identifiers 7

IdentifierTypeStateIssuer
138897OtherMIGREAT LAKES
110F336360OtherMIBCBSM
207R00000XOtherMITAXONOMY
2790874MedicaidMI
4301051935OtherMILICENSE
F22180OtherMIHAP
1346398971OtherMIGROUP NPI

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
I20070315000354 MI Practitioner - Internal Medicine 8123121910 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
72.87 of 100Reported as group
Quality
52.13
Improvement activities
40
Cost
66.42

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Academic Internal Medicine Specialists PLLC Internal Medicine CurrentSince Jan 1, 2007 Accepting new patients
Outer Drive Partners LLC Past Accepting new patients

Locations

6071 W Outer Dr
Ste 7
Detroit, MI 48235
Phone (313) 966-3300

6071 W Outer Dr
Detroit, MI 48235
Phone (313) 966-3300

6001 W Outer Dr
Ste 114
Detroit, MI 48235
Phone (313) 966-9095

28411 Northwestern Hwy
Ste 1050
Southfield, MI 48034
Phone (248) 354-4709

26677 W 12 Mile Rd
#B6
Southfield, MI 48034
Phone (248) 354-4709

26677 W 12 Mile Rd
Ste B6
Southfield, MI 48034

Interoperability endpoints

  • Direct secure messaging: sjones-l@direct.dmc.org

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": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1902862667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 674147",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482674147",
            "telephone_number": "248-354-4709",
            "fax_number": "248-354-4807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26677 W 12 MILE RD # B6",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341514",
            "telephone_number": "248-354-4709",
            "fax_number": "248-354-4807"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28411 Northwestern Hwy",
            "address_2": "Suite 1050",
            "address_purpose": "LOCATION",
            "city": "Southfield",
            "state": "MI",
            "postal_code": "480345544",
            "country_code": "US",
            "telephone_number": "248-354-4709",
            "fax_number": "248-354-4807",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "SANDRA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-21",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301051935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT LAKES",
            "identifier": "138897",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "110F336360",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY",
            "identifier": "207R00000X",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2790874",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "4301051935",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAP",
            "identifier": "F22180",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1346398971",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.