DR. JONATHAN IM (MD) – Neuroradiology Physician, NPI 1689231250
Neuroradiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,650 DIAGNOSTIC RADIOLOGY in MI
Provider Addresses for DR. JONATHAN IM (MD)
840 Oakwood Blvd
Dearborn, MI 481242319
Phone: (313) 359-7600
Type: Location
Beaumont Hospital - Dearborn, 18101, Oakwood Boulevard, Dearborn, Wayne County, Michigan, 48124, United States
DEARBORN, MI 481244089
Phone: (313) 593-7000
Type: Mailing
1959 NE PACIFIC STREET NW011 BOX : 357233
SEATTLE, WA 981954089
Phone: (206) 598-5130
Type: Mailing
1959 NE PACIFIC ST # NW011
SEATTLE, WA 981954089
Phone: (206) 598-5130
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2025-09-23
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20240603000325 | I | Diagnostic Radiology | MI | TBD |
| I20250923004561 | I | Diagnostic Radiology | WA | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 48124)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology | MI | |
| Diagnostic Radiology | MI | |
| Diagnostic Radiology, Interventional Radiology | MI | |
| Diagnostic Radiology | MI | |
| Interventional Radiology | MI | |
| Diagnostic Radiology | MI | |
| Diagnostic Radiology | NY | |
| Nurse Practitioner | MI | |
| Diagnostic Radiology | MI | |
| - | MI |
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