JENNIFER R IDRISSU NP
NPI 1053931873
Nurse Practitioner - Primary Care in Royal Oak, MI

Q: What is Jennifer Idrissu's NPI number?

The NPI number for Jennifer Idrissu is 1053931873. It was assigned to this individual provider in the NPPES registry on April 22, 2020. The provider is also known as Jennifer R Johnson Np.

Q: What is Jennifer Idrissu's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Q: When was this NPI record last updated?

The NPPES record for Jennifer Idrissu was last updated on June 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 22, 2020PECOS EnrolledAccepts Medicare Assignment

3455 STARR RD, ROYAL OAK, MI 48073(248) 288-9340(248) 965-3029 Get Directions Write a Review

NPPES record last updated: June 18, 2024. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Jun 18, 2024, Aug 31, 2023, Jun 1, 2020 and 1 more (4 updates tracked since 2020).

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About Jennifer R Idrissu Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JENNIFER R IDRISSU NP (NPI 1053931873) is an individual primary care provider in Royal Oak, Michigan, licensed in Michigan (4704245483) and active in the NPI registry since April 2020. She is enrolled in Medicare PECOS, is affiliated with Henry Ford Health Hospital, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1053931873

Entity TypeIndividualFemale

Primary Taxonomy363LP2300X

Provider Legal NameJENNIFER R IDRISSUCredential: NP

Location Address3455 STARR RDRoyal Oak, MI 48073-2100

Mailing Address5280 Metropolitan PkwySterling Heights, MI 48310-4005 · (248) 290-3111 · Fax (248) 290-3100

Phone(248) 288-9340

Fax(248) 965-3029

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateApril 22, 2020

Last NPPES UpdateJune 18, 20244 updates tracked since enumeration

NPPES CertifiedJune 18, 2024

✔ NPI 1053931873 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP2300X

License✔ Licensed in MI · 4704245483

Also ListedNurse PractitionerTaxonomy 363L00000X · License 4704245483 (MI)

3455 STARR RD, Royal Oak, MI 48073

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Other Names 1

Former Name (1)Jennifer R Johnson Np

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jennifer R Idrissu Np is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6406277334

PECOS Enrollment IDI20200602001254

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

41 services32 patients

Dialysis services, 2-3 physician visits per month (20 years or older) 90961

Dialysis is a treatment that performs the function of healthy kidneys if they're not working properly. It removes waste and excess fluid from your blood. 2-3 physician visits per month are recommended for monitoring your health and adjusting your treatment as needed. This service is available for those aged 20 years and older.

36 services23 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

15 services15 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Henry Ford Health Hospital

Acute Care Hospitals · Detroit, MI

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230053

Location2799 W Grand BlvdDetroit, MI 48202 · Wayne County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48073 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$90.76 typical visit price

range $58.04 – $177.36

Typical copayment $22.69 (range $14.51 – $44.34)

Most-billed visit code 99203

Established Patient

$102.35 typical visit price

range $18.32 – $143.49

Typical copayment $25.58 (range $4.58 – $35.87)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHRISTINA KHOURI NP

Nurse Practitioner (Family)

3455 STARR RD
ROYAL OAK, MI 48073

Oakland County (248) 288-9340

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jennifer Idrissu's NPI number?

The NPI number for Jennifer Idrissu is 1053931873. It was assigned to this individual provider in the NPPES registry on April 22, 2020. The provider is also known as Jennifer R Johnson Np.

Where is Jennifer Idrissu located?

Jennifer Idrissu practices at 3455 Starr Rd, Royal Oak, MI 48073. The listed phone number is (248) 288-9340.

What is Jennifer Idrissu's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Is Jennifer Idrissu enrolled in Medicare?

Yes. Jennifer Idrissu is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Jennifer Idrissu accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and Priority Health list Jennifer Idrissu as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Jennifer Idrissu affiliated with any hospitals?

According to CMS data, Jennifer Idrissu is affiliated with Henry Ford Health Hospital.

When was this NPI record last updated?

The NPPES record for Jennifer Idrissu was last updated on June 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.