JENNIFER B MITSUYA D.O.
NPI 1336405554
Pediatrics - Pediatric Gastroenterology in Royal Oak, MI

Q: What is Jennifer Mitsuya's NPI number?

The NPI number for Jennifer Mitsuya is 1336405554. It was assigned to this individual provider in the NPPES registry on April 2, 2012. The provider is also known as Jennifer M. Bordato D.O..

Q: What is Jennifer Mitsuya's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Gastroenterology, with taxonomy code 2080P0206X.

Q: When was this NPI record last updated?

The NPPES record for Jennifer Mitsuya was last updated on October 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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 02, 2012PECOS Enrolled

3535 W 13 MILE RD STE 707, ROYAL OAK, MI 48073(248) 551-0487(248) 551-3696 Get Directions Write a Review

NPPES record last updated: October 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 22, 2020, Oct 31, 2018, May 16, 2017 (3 updates tracked since 2017).

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About Jennifer B Mitsuya D.o. NPPES

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

JENNIFER B MITSUYA D.O. (NPI 1336405554) is an individual pediatric gastroenterology provider in Royal Oak, Michigan, licensed in Michigan (5101019846) and active in the NPI registry since April 2012. She is enrolled in Medicare PECOS and maintains a secondary practice location in Detroit.

NPPES Registry Identity

NPI1336405554

Entity TypeIndividualFemale

Primary Taxonomy2080P0206X

Provider Legal NameJENNIFER B MITSUYACredential: D.O.

Location Address3535 W 13 MILE RD STE 707Royal Oak, MI 48073

Mailing Address26901 Beaumont BoulevardSouthfield, MI 48033 · (947) 522-1858 · Fax (248) 350-4123

Phone(248) 551-0487

Fax(248) 551-3696

Sole ProprietorNo

Enumeration DateApril 2, 2012

Last NPPES UpdateOctober 22, 20203 updates tracked since enumeration

NPPES CertifiedOctober 22, 2020

✔ NPI 1336405554 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code2080P0206X

License✔ Licensed in MI · 5101019846

Definition

A pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs.

3535 W 13 MILE RD STE 707, Royal Oak, MI 48073

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Other Names 1

Former Name (1)Jennifer M. Bordato D.o.

Secondary Practice Location 1

Location 13901 Beaubien StDetroit, MI 48201-2119 · Phone (313) 745-5533 · Fax (313) 993-7118

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health 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 (PECOS)

Jennifer B Mitsuya D.o. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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

$134.28 typical visit price

range $58.04 – $177.36

Typical copayment $33.57 (range $14.51 – $44.34)

Most-billed visit code 99204

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 13

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

DR. JAMAL KRIEM MD

Pediatrics (Pediatric Gastroenterology)

3535 W 13 MILE RD STE 707
ROYAL OAK, MI 48073

Oakland County (248) 551-0487

CATHY PATTY-RESK CPNP

Nurse Practitioner (Pediatrics)

3535 W 13 MILE RD STE 707
ROYAL OAK, MI 48073

Oakland County (248) 551-0487

DR. NEAL BENJAMIN BLATT M.D.

Pediatrics (Pediatric Nephrology)

3535 W 13 MILE RD STE 707
ROYAL OAK, MI 48073

Oakland County (248) 551-0487

DR. JULIE M SURHIGH MD

Pediatrics (Pediatric Endocrinology)

3535 W 13 MILE RD STE 707
ROYAL OAK, MI 48073

Oakland County (248) 551-0487

RUBA BARBAR M.D.

Pediatrics

3535 W 13 MILE RD STE 707
ROYAL OAK, MI 48073

Oakland County (248) 551-0487

MOHAMMAD OSMAN

Pediatrics (Pediatric Gastroenterology)

3535 W 13 MILE RD STE 707, BEAUMONT CHILDREN'S HOSPITAL PEDIATRIC GASTROENTEROLOGY
ROYAL OAK, MI 48073

Oakland County (248) 551-0487

SHABANA KALLADI PUTHANPURAYIL M.D

Pediatrics (Pediatric Endocrinology)

3535 W 13 MILE RD STE 707
ROYAL OAK, MI 48073

Oakland County (248) 551-0487

MATTHEW DAVID ADAMS MD

Pediatrics (Pediatric Rheumatology)

3535 W 13 MILE RD STE 707
ROYAL OAK, MI 48073

Oakland County (248) 551-0487

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 Mitsuya's NPI number?

The NPI number for Jennifer Mitsuya is 1336405554. It was assigned to this individual provider in the NPPES registry on April 2, 2012. The provider is also known as Jennifer M. Bordato D.O..

Where is Jennifer Mitsuya located?

Jennifer Mitsuya practices at 3535 W 13 Mile Rd Ste 707, Royal Oak, MI 48073. The listed phone number is (248) 551-0487.

What is Jennifer Mitsuya's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Gastroenterology, with taxonomy code 2080P0206X.

Is Jennifer Mitsuya enrolled in Medicare?

Yes. Jennifer Mitsuya is registered in the Medicare PECOS enrollment system.

What insurance does Jennifer Mitsuya accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 3 other insurers list Jennifer Mitsuya 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.

When was this NPI record last updated?

The NPPES record for Jennifer Mitsuya was last updated on October 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.