MUMTAZ ALAM MEMON (MD) – Cardiovascular Disease Physician, NPI 1215904255
Cardiovascular Disease Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
7,218 INTERNAL MEDICINE in MI
Provider Addresses for MUMTAZ ALAM MEMON (MD)
5325 ELLIOTT DR
SUITE 203
YPSILANTI, MI 481978633
Phone: (734) 712-8000
Fax: (734) 712-4319
Type: Location
309 PAGE AVE
JACKSON, MI 492012419
Phone: (517) 205-1234
Fax: (517) 205-1050
Type: Mailing
309 PAGE AVE STE 203
JACKSON, MI 492012419
Phone: (517) 205-1234
Fax: (172) 051-0505
Type: Location
Domino's Farms Office Park, 24, Frank Lloyd Wright Drive, Domino Farms, Ann Arbor Charter Township, Washtenaw County, Michigan, 48105, United States
PO BOX 0446 - LOBBY J
ANN ARBOR, MI 481059484
Phone: (734) 747-6766
Fax: (734) 222-3100
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $17.
Total Amount is formed as General ($17) + Research ($0) + Ownership ($0) = $17.
Last reported payment date: 2023-10-04 • Largest payer in this snapshot: Cook Medical LLC ($17).
Total Amount
$17
General + Research + Ownership
Payments
1
Total payment records
General Amount
$17
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-10-04
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Cook Medical LLC | $17 |
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: 2004-02-12
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040212000881 | I | Cardiovascular Disease (Cardiology) | MI | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 93010 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | 1,296 | 983 | $0 |
| 93306 | Ultrasound of heart with color-depicted blood flow, rate, direction and valve function | 292 | 292 | $0 |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 285 | 197 | $0 |
| 93018 | Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician | 144 | 143 | $0 |
| 93016 | Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician | 143 | 142 | $0 |
Insurance plans in this area (ZIP 48197)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| CARDIOVASCULAR DISEASE (CARDIOLOGY) | MI | 93010 | Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report | 2722 | 1241 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MI | |
| U R O L O G Y | MI | |
| - | MI | |
| - | MI | |
| Cardiac Electrophysiology, Cardiovascular Disease (Cardiology) | MI | |
| - | MI | |
| Physician Assistant | OH | |
| - | MI | |
| - | MI | |
| - | MI |
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