NPIMap

Individual provider Active NPI

Julie Diane Mladic, DO

  • Obstetrics & Gynecology Physician
  • Dearborn, MI
National Provider Identifier
1962671339
Registry record updated Oct 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
5101016226 Issued in MI
Practice address
4900 Mercury Dr Ste 201
Dearborn, MI 48126-2947
Phone
(313) 790-8000
NPI assigned
Feb 29, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 5101016226 MI Primary

Addresses

Primary practice location

4900 Mercury Dr Ste 201
Dearborn, MI 48126-2947

Mailing address

26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jmladic144596@direct.beaumont.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081209000624 MI Practitioner - Obstetrics/Gynecology 9133280126 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Oakwood Ambulatory LLCGroup PAC ID 1850282914, 271 clinicians

Practice addresses (Care Compare)

18101 Oakwood Blvd
Dearborn, MI 48124-4089
Phone (313) 593-7000

201 3Rd St
Suite 200
Belleville, MI 48111-2605
Phone (734) 697-9065

4700 Schaefer Rd
Dearborn, MI 48126-3743

Hospital & facility affiliations

  • Beaumont Hospital - Dearborn Hospital, Dearborn, MI, CCN 230020
  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130
  • Corewell Health Wayne Hospital Hospital, Wayne, MI, CCN 230142

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101016226MIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oakwood Ambulatory, LLC CurrentSince Aug 4, 2016 Accepting new patients
Oakwood Ambulatory LLC Obstetrics & Gynecology CurrentSince Aug 4, 2016 Accepting new patients
Oakwood Healthcare Inc Past Accepting new patients
Oakwood Healthcare, Inc. Past Accepting new patients

Locations

201 3rd St
Ste 200
Belleville, MI 48111
Phone (734) 697-9065

4700 Schaefer Rd
Ste 310
Dearborn, MI 48126
Phone (947) 523-4680

4900 Mercury Dr
Ste 201
Dearborn, MI 48126
Phone (313) 565-5743

26901 Beaumont Blvd
Ste 3D
Southfield, MI 48033
Phone (947) 522-1860

Interoperability endpoints

  • Direct secure messaging: jmladic144596@direct.beaumont.edu
  • Direct secure messaging: jmladic1247256@epic00.shdirect.org

Organizations & group practices 4

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 6

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": "1204243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1962671339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849",
            "fax_number": "248-335-2394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 MERCURY DR STE 201",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262947",
            "telephone_number": "313-790-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MLADIC",
        "first_name": "JULIE",
        "middle_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-29",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "5101016226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmladic144596@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "4900 Mercury Dr Ste 201",
            "city": "Dearborn",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481262947",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.