Active NPI
Ijeoma Nnodim Opara, MD
- Internal Medicine Physician
- Detroit, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 4301092567
- Practice address
- 4201 St. Antoine Ste 6a & 6B
General Medicine Ambulatory Practice
Detroit, MI 48201-1804 - Phone
- (313) 745-4627
- Fax
- (313) 966-7305
- NPI assigned
- Oct 28, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 4301092567 | MI | |
| Internal Medicine Physician | 207R00000X | 4301092567 | MI | Primary |
Addresses
Primary practice location
4201 St. Antoine Ste 6a & 6B
General Medicine Ambulatory Practice
Detroit, MI 48201-1804
Mailing address
400 Mack Ave Ste 2
Detroit, MI 48201-2136
Phone (313) 448-9006
Other practice location 1
400 Mack Avenue
Suite 2 East
Detroit, MI 48201-4820
Phone (313) 448-9650
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Wayne State University School of Medicine, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3980 John R St
Detroit, MI 48201-2018
Phone (313) 745-8040
3990 John R St
Detroit, MI 48201-2018
4100 John R St
Detroit, MI 48201-2013
Phone (800) 527-6266
4201 Saint Antoine St
Detroit, MI 48201-2153
Hospital & facility affiliations
- Detroit Receiving Hospital
- Harper University Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Physician Group | Current | Accepting new patients | |
| University Physician Group | Internal Medicine | Current | Accepting new patients |
| VHS Harper-Hutzel Hospital Inc | Past | Accepting new patients | |
| University Physician Group | Past | Accepting new patients | |
| VHS Detroit Receiving Hospital Inc | Past | Accepting new patients |
Locations
400 Mack Ave
Ste 2
Detroit, MI 48201
Phone (313) 448-9006
4201 Saint Antoine St
Ste 6A
Detroit, MI 48201
Phone (313) 745-4230
4100 John R St
Detroit, MI 48201
Phone (313) 576-8530
50 E Canfield St
Detroit, MI 48201
Phone (313) 577-9704
1560 E Maple Rd
Ste 400
Troy, MI 48083
1560 E Maple Rd
Ste 200
Troy, MI 48083
Phone (248) 581-5200
Interoperability endpoints
- ijeoma.nnodim.1@19711.direct.athenahealth.com
- innodim@direct.dmc.org
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Internal Medicine Physician
- Detroit, MI
- NPI 1447299797
-
- Optometrist
- Detroit, MI
- NPI 1063452233
-
- Counselor
- Detroit, MI
- NPI 1447465661
-
- General Acute Care Hospital
- Detroit, MI
- NPI 1619289998
-
- General Acute Care Hospital
- Detroit, MI
- NPI 1427360700
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Detroit, MI
- NPI 1619289998
-
- General Acute Care Hospital
- Detroit, MI
- NPI 1427360700
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595376000000",
"number": "1003069766",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 MACK AVE STE 2",
"city": "DETROIT",
"state": "MI",
"postal_code": "482012136",
"telephone_number": "313-448-9006",
"fax_number": "313-966-7305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4201 ST. ANTOINE STE 6A & 6B",
"address_2": "GENERAL MEDICINE AMBULATORY PRACTICE",
"city": "DETROIT",
"state": "MI",
"postal_code": "482011804",
"telephone_number": "313-745-4627",
"fax_number": "313-966-7305"
}
],
"practiceLocations": [
{
"address_1": "400 Mack Avenue",
"address_2": "Suite 2 East",
"address_purpose": "LOCATION",
"city": "Detroit",
"state": "MI",
"postal_code": "482014820",
"country_code": "US",
"telephone_number": "313-448-9650",
"fax_number": "313-448-9966",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "OPARA",
"first_name": "IJEOMA",
"middle_name": "NNODIM",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-28",
"last_updated": "2020-07-22",
"certification_date": "2020-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MI",
"license": "4301092567",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MI",
"license": "4301092567",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.