Organization Active NPI

Sam Ajluni, M.D. PLLC

  • Psychiatry Physician
  • Southfield, MI
National Provider Identifier
1922431808
Registry record updated Oct 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
SAM AJLUNI, M.D. PLLC
Practice address
26677 W. 12 Mile Rd PMB 3272
Southfield, MI 48034
Phone
(248) 808-4644
Fax
(248) 288-3770
NPI assigned
Aug 15, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2024

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

Authorized official

Name
Dr. Sam Ajluni, M.D,NPI 1700888179
Title
President/Owner
Phone
(248) 808-4644

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

26677 W. 12 Mile Rd PMB 3272
Southfield, MI 48034

Mailing address

26677 W. 12 Mile Rd PMB 3272
Southfield, MI 48034
Phone (248) 808-4644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131220001249 MI Part B Supplier - Clinic/Group Practice 2668609520 Receives reassigned benefits from 1 practitioner
Practice locations: Southfield, MI

National Provider Directory

National Provider Directory

Locations

1800 W 14 Mile Rd
Ste C
Royal Oak, MI 48073
Phone (248) 307-7738

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1376524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729987200000",
    "number": "1922431808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26677 W. 12 MILE RD PMB 3272",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "48034",
            "telephone_number": "248-808-4644",
            "fax_number": "248-288-3770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26677 W. 12 MILE RD PMB 3272",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "48034",
            "telephone_number": "248-808-4644",
            "fax_number": "248-288-3770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAM AJLUNI, M.D. PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-15",
        "last_updated": "2024-10-27",
        "certification_date": "2024-10-27",
        "status": "A",
        "authorized_official_last_name": "AJLUNI",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "248-808-4644",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D,"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.