Individual provider Active NPI

Ijeoma Nnodim Opara, MD

  • Internal Medicine Physician
  • Detroit, MI
National Provider Identifier
1003069766
Registry record updated Jul 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301092567 Issued in MI
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

Updated by the provider on Jul 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131101000687 MI Practitioner - Internal MedicinePractitioner - Pediatric Medicine 9436384286 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Wayne State University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Physician GroupGroup PAC ID 8628087681, 399 clinicians

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 Hospital, Detroit, MI, CCN 230273
  • Harper University Hospital Hospital, Detroit, MI, CCN 230104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Group CurrentSince Oct 1, 2013 Accepting new patients
University Physician Group Internal Medicine CurrentSince Oct 1, 2013 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

  • Direct secure messaging: ijeoma.nnodim.1@19711.direct.athenahealth.com
  • Direct secure messaging: 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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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

Verify at the official NPI Registry.