JENNIFER B MITSUYA D.O.
NPI 1336405554
Pediatrics - Pediatric Gastroenterology in Royal Oak, MI
NPI Status: Active since April 02, 2012
Contact Information
3535 W 13 MILE RD STE 707
ROYAL OAK, MI
ZIP 48073
Phone: (248) 551-0487
Fax: (248) 551-3696
- Individual
- Female
- Pediatrics
- Pediatric Gastroenterology
- Accepts Insurance
- PECOS Enrolled
About JENNIFER MITSUYA
This page provides the complete NPI Profile along with additional information for Jennifer Mitsuya, a pediatrician established in Royal Oak, Michigan with a medical specialization in Pediatrics, focusing in pediatric gastroenterology . The healthcare provider is registered in the NPI registry with number 1336405554 assigned on April 2012. The practitioner's primary taxonomy code is 2080P0206X with license number 5101019846 (MI). The provider is registered as an individual and her NPI record was last updated 5 years ago.
- NPI
- 1336405554
- Provider Name
- JENNIFER B MITSUYA D.O.
- Other Name
- JENNIFER M. BORDATO D.O.
- Other Name Type
- Former Name (1)
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 3535 W 13 MILE RD STE 707 ROYAL OAK, MI 48073
- Location Phone
- (248) 551-0487
- Location Fax
- (248) 551-3696
- Mailing Address
- 26901 BEAUMONT BOULEVARD SOUTHFIELD, MI 48033
- Mailing Phone
- (947) 522-1858
- Mailing Fax
- (248) 551-3696
- Is Sole Proprietor?
- No
- Enumeration Date
- 04-02-2012
- Last Update Date
- 10-22-2020
- Code Navigator
A pediatrician like Jennifer Mitsuya is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.
Location Map
Secondary Locations
- 3901 Beaubien St
Detroit, MI 48201
(313) 745-5533
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pediatrics Pediatric Gastroenterology
- Taxonomy Code
- 2080P0206X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 5101019846
- License State
- MI
- Taxonomy Description
- 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.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Clear Silver - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Clear Gold - HMO
- Clear Gold + Vision + Adult Dental - HMO
- Clear Silver - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Blue Cross� Preferred HMO Bronze Extra - HMO
- Blue Cross� Preferred HMO Bronze Saver HSA - HMO
- Blue Cross� Preferred HMO Bronze Secure - HMO
- Blue Cross� Preferred HMO Gold - HMO
- Blue Cross� Preferred HMO Gold Extra - HMO
- Blue Cross� Preferred HMO Silver - HMO
- Blue Cross� Preferred HMO Silver Extra - HMO
- Blue Cross� Preferred HMO Silver Saver - HMO
- Blue Cross� Preferred HMO Value - HMO
- Blue Cross� Select HMO Bronze Extra - HMO
- Blue Cross� Premier PPO Bronze Extra - PPO
- Blue Cross� Premier PPO Bronze HSA - PPO
- Blue Cross� Premier PPO Bronze Secure - PPO
- Blue Cross� Premier PPO Gold - PPO
- Blue Cross� Premier PPO Gold Extra - PPO
- Blue Cross� Premier PPO Silver - PPO
- Blue Cross� Premier PPO Silver Extra - PPO
- Blue Cross� Premier PPO Silver Saver HSA - PPO
- Blue Cross� Premier PPO Value - PPO
- Bronze First - HMO
- Bronze First Adult Vision & Fitness - HMO
- Diabetes Gold - HMO
- Diabetes Gold Adult Vision & Fitness - HMO
- Diabetes Silver - HMO
- Diabetes Silver Adult Vision & Fitness - HMO
- Gold - HMO
- Gold Adult Vision & Fitness - HMO
- HDHP Preventive Silver - HMO
- Healthy Heart Gold - HMO
- MHP Bronze - HMO
- MHP Bronze Saver (Expanded) - HMO
- MHP Expanded Bronze Standard - HMO
- MHP Gold - HMO
- MHP Gold Standard - HMO
- MHP Silver Exchange - HMO
- MHP Silver Exchange Rewards - HMO
- MHP Silver Standard - HMO
- MHP Young Adult/Catastrophic - HMO
- Gold 1 - HMO
- Gold 1 with Adult Vision Services - HMO
- Gold 8 - HMO
- Silver 1 - HMO
- Silver 1 with Adult Vision Services - HMO
- Silver 12 with First 4 Primary Care Visits Free - HMO
- Silver 8 - HMO
- MyPriority Balanced Silver - HMO
- MyPriority Balanced Silver Southeast Michigan Network - HMO
- MyPriority Enhanced Gold Southeast Michigan Network - HMO
- MyPriority Premier Silver - HMO
- MyPriority Premier Silver Southeast Michigan Network - HMO
- MyPriority Standard Bronze - HMO
- MyPriority Standard Bronze - Southeast Michigan Network - HMO
- MyPriority Standard Bronze - Travel - HMO
- MyPriority Standard Gold - HMO
- MyPriority Standard Gold Southeast Michigan Network - HMO
- UHC Bronze Copay Focus (No Referrals) - HMO
- UHC Bronze Standard (No Referrals) - HMO
- UHC Bronze Value (No Referrals) - HMO
- UHC Gold Advantage (No Referrals) - HMO
- UHC Gold Advantage+ (Dental + Vision, No Referrals) - HMO
- UHC Gold Copay Focus (No Referrals) - HMO
- UHC Gold Standard (No Referrals) - HMO
- UHC Silver Advantage (No Referrals) - HMO
- UHC Silver Advantage+ (Dental + Vision, No Referrals) - HMO
- UHC Silver Standard (No Referrals) - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Jennifer Mitsuya is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 48073 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $134.28
- Minimum New Patient Price $58.04
- Maximum New Patient Price $177.36
- Average New Patient Copayment $33.57
- Minimum New Patient Copayment $14.51
- Maximum New Patient Copayment $44.34
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $102.35
- Minimum Established Patient Price $18.32
- Maximum Established Patient Price $143.49
- Average Established Patient Copayment $25.58
- Minimum Established Patient Copayment $4.58
- Maximum Established Patient Copayment $35.87
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 3 | 3 | 6 | 4 | 0 | 5 | 5 | 5 | 4 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 6 | 6 | 8 | 0 | 10 | 5 | 10 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 6 + 6 + 8 + 0 + 1 + 0 + 5 + 1 + 0 + 24 = 56 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 56 = 4 | 4 | ||||||||
The NPI number 1336405554 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 11 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1891116950 | ADRIANE LEMANSKI RD Individual | Dietitian, Registered | 3535 W 13 MILE RD STE 707 ROYAL OAK, MI 48073 (248) 551-0487 |
| 1144344771 | DR. NEAL BENJAMIN BLATT M.D. Individual | Pediatrics (Pediatric Nephrology) | 3535 W 13 MILE RD STE 707 ROYAL OAK, MI 48073 (248) 551-0487 |
| 1295869550 | DR. JULIE M SURHIGH MD Individual | Pediatrics (Pediatric Endocrinology) | 3535 W 13 MILE RD STE 707 ROYAL OAK, MI 48073 (248) 551-0487 |
| 1689861049 | INDU JAIN MD Individual | Pediatrics | 3535 W 13 MILE RD STE 707 BEAUMONT PEDIATRIC PULMONARY MEDICINE ROYAL OAK, MI 48073 (248) 551-0487 |
| 1376823286 | SHABANA KALLADI PUTHANPURAYIL M.D Individual | Pediatrics (Pediatric Endocrinology) | 3535 W 13 MILE RD STE 707 ROYAL OAK, MI 48073 (248) 551-0487 |
| 1346407525 | MOHAMMAD OSMAN Individual | Pediatrics (Pediatric Gastroenterology) | 3535 W 13 MILE RD STE 707 BEAUMONT CHILDREN'S HOSPITAL PEDIATRIC GASTROENTEROLOGY ROYAL OAK, MI 48073 (248) 551-0487 |
| 1750376877 | M BASSEM HOSEIN DEKELBAB MD Individual | Pediatrics | 3535 W 13 MILE RD STE 707 ROYAL OAK, MI 48073 (248) 551-0487 |
| 1013120732 | DR. JAMAL KRIEM MD Individual | Pediatrics (Pediatric Gastroenterology) | 3535 W 13 MILE RD STE 707 ROYAL OAK, MI 48073 (248) 551-0487 |
| 1326574369 | RUBA BARBAR M.D. Individual | Pediatrics | 3535 W 13 MILE RD STE 707 ROYAL OAK, MI 48073 (248) 551-0487 |
| 1750319232 | DR. THOMAS LANE SUTTON M.D. Individual | Pediatrics (Pediatric Gastroenterology) | 3535 W 13 MILE RD STE 707 ROYAL OAK, MI 48073 (248) 551-0487 |
| 1437197555 | MATTHEW DAVID ADAMS MD Individual | Pediatrics (Pediatric Rheumatology) | 3535 W 13 MILE RD STE 707 ROYAL OAK, MI 48073 (248) 551-0487 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1336405554, enumerated in the NPI registry as an "individual" on April 02, 2012
The provider is located at 3535 W 13 Mile Rd Ste 707 Royal Oak, Mi 48073 and the phone number is (248) 551-0487
The provider's speciality is Pediatrics with taxonomy code 2080P0206X with a focus in Pediatric Gastroenterology
The provider might be accepting Accepts: Ambetter from Meridian, Ambetter Health, Blue Care. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $134.28 with an average copayment of $33.57 for new patient appointments. Established patients should expect a typical charge of $102.35 and an average copayment of 25.58. Please review your insurance plan or contact the provider directly to determine your specific costs.
This NPI record was last updated on April 02, 2012. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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