JOLIAN SAM KATHAWA (D.O.) – Internal Medicine Physician, NPI 1083065916

JOLIAN SAM KATHAWA (D.O.) is a healthcare provider. based in Warren, Michigan. specializing in INTERNAL MEDICINE, GASTROENTEROLOGY. They hold the professional credentials D.O.. They hold a License No. 5101022774 (MI). The NPI Number for JOLIAN SAM KATHAWA (D.O.) is 1083065916

Main info

Male
Sole Proprietor
10 Years Of Experience
Accepts Medicare Assignment
Name
JOLIAN SAM KATHAWA (D.O.)
NPI
1083065916
Phone
(586) 582-6630
Address
11885 E 12 MILE RD STE 300A
Enumeration Date
22 June 2016
Last Update Date
6 March 2026

Doctor Profile

Medical School Name
AT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
Secondary Phone
2484718000
Graduation Year
2016 (10 years ago)
PAC ID
7416248216
Group Practice PAC ID
3274578661
Professional Enrollment ID
I20200424001012
Address ID
MI483365919FA28050AVEX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience47
Completeness85
Years active:9State licenses:1Digital endpointsOther names

7,218 INTERNAL MEDICINE in MI

Provider Addresses for JOLIAN SAM KATHAWA (D.O.)

  • 11885 E 12 MILE RD STE 300A

    WARREN, MI 480933467

    Phone: (586) 582-6630

    Fax: (586) 582-6631

    Type: Mailing

  • 1 William Carls Dr Ste 220

    Commerce Twp, MI 483822201

    Phone: (248) 579-9220

    Fax: (248) 426-7350

    Type: Location

  • 27301 Dequindre Rd Ste 314

    Madison Heights, MI 480713459

    Phone: (248) 579-9220

    Fax: (248) 426-7350

    Type: Location

  • 23133 ORCHARD LAKE RD STE 200

    FARMINGTON, MI 483363279

    Phone: (248) 579-9220

    Fax: (248) 426-7350

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 150 Open Payments records for all available years, with a total value of $3,351.

Total Amount is formed as General ($3,351) + Research ($0) + Ownership ($0) = $3,351.

Last reported payment date: 2024-12-23 • Largest payer in this snapshot: ABBVIE INC. ($642).

Total Amount

$3,351

General + Research + Ownership

Payments

150

Total payment records

General Amount

$3,351

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-23

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-04-24

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20200424001012IInternal MedicineMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes285152$0
99222Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes9892$0
43239Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope8379$0
99213Established patient office or other outpatient visit, 20-29 minutes6357$0
99214Established patient office or other outpatient visit, 30-39 minutes6354$0
View full utilization report →

Insurance plans in this area (ZIP 48093)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3274578661View full group profile
NameSpecialtyState
G A S T R O E N T E R O L O G YMI
P A T H O L O G YTN
G A S T R O E N T E R O L O G YMI
-MI
G A S T R O E N T E R O L O G YMI
Internal MedicineMI
-MI

Reviews

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Frequently asked questions

Is JOLIAN SAM KATHAWA (D.O.) listed with a National Provider Identifier?
Yes — JOLIAN SAM KATHAWA (D.O.) has NPI 1083065916 on file in the registry.
Active or inactive — what applies to JOLIAN SAM KATHAWA (D.O.)?
You should see JOLIAN SAM KATHAWA (D.O.) as active in CMS-hosted NPPES data.
What area of care is associated with JOLIAN SAM KATHAWA (D.O.)?
JOLIAN SAM KATHAWA (D.O.)'s record emphasizes Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Is JOLIAN SAM KATHAWA (D.O.) associated with Warren?
Public fields place JOLIAN SAM KATHAWA (D.O.) around Warren, Michigan. Always confirm the exact site before visiting.
Can I trust this NPI listing for JOLIAN SAM KATHAWA (D.O.)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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