Individual provider Active NPI

Jaafar Elmenini, MD

  • Internal Medicine Physician
  • Detroit, MI
National Provider Identifier
1952983538
Registry record updated Apr 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301504925APP21 Issued in MI
Practice address
3990 John R St
Detroit, MI 48201-2018
Phone
(313) 745-8040
NPI assigned
Apr 23, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2021

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 4301504925APP21 MI Primary

Addresses

Primary practice location

3990 John R St
Detroit, MI 48201-2018

Mailing address

441 N Gulley Rd
Dearborn Heights, MI 48127-3463
Phone (313) 574-7832

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
I20210615002497 MI Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 0143620971

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Wayne State University School of Medicine, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

15001 Kercheval Ave
Grosse Pointe Park, MI 48230-1361

8635 Congress Dr
Canton, MI 48187-2020

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301504925APP21MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mirna Farhat MD, PLC PastSince Jul 15, 2026 Accepting new patients

Organizations & group practices 1

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": "1619136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619136000000",
    "number": "1952983538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 N GULLEY RD",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481273463",
            "telephone_number": "313-574-7832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3990 JOHN R ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012018",
            "telephone_number": "313-745-8040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELMENINI",
        "first_name": "JAAFAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-23",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301504925APP21",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.