JISHA DUDEESH (CNP) – Nurse Practitioner, NPI 1902356272
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8,106 NURSE PRACTITIONER in MI
Provider Addresses for JISHA DUDEESH (CNP)
24 FRANK LLOYD WRIGHT DRIVE
SUITE J2000
ANN ARBOR, MI 48105
Phone: (734) 747-6766
Fax: (734) 222-3100
Type: Mailing
6777 W Maple Rd
West Bloomfield, MI 483223013
Phone: (313) 622-1380
Fax: (313) 622-1380
Type: Location
22151, Moross Road, Detroit, Wayne County, Michigan, 48236, United States
PROFESSIONAL BUILDING ONE
DETROIT, MI 482362167
Phone: (313) 343-7107
Type: Mailing
44555 WOODWARD AVE
PONTIAC, MI 48341
Phone: (248) 858-6104
Type: Location
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 $40.
Total Amount is formed as General ($40) + Research ($0) + Ownership ($0) = $40.
Last reported payment date: 2023-09-26 • Largest payer in this snapshot: UCB, Inc. ($40).
Total Amount
$40
General + Research + Ownership
Payments
1
Total payment records
General Amount
$40
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-09-26
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| UCB, Inc. | $40 |
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: 2018-11-21
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 |
|---|---|---|---|---|
| I20181121002014 | I | Nurse Practitioner | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 48105)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Hospitalist, Internal Medicine | MI | |
| Interventional Radiology | MI | |
| Cardiovascular Disease (Cardiology) | MI | |
| Physician Assistant | MI | |
| Physician Assistant | MI | |
| - | MI | |
| - | MI | |
| Internal Medicine, Geriatric Medicine | MI | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MI | |
| Hospitalist, Internal Medicine | MI |
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