Blue Water Primary Care

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BLUE WATER PRIMARY CARE

Practice address

3953 24TH Ave
Fort Gratiot, MI 48059-4193

Phone

(734) 299-0712

NPI assigned

Aug 28, 2025

Last updated

Jan 28, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ibrahim Dabaja, PA-C, PH.D.NPI 1053592238

Title

Chief Operating Officer

Phone

(810) 363-9337

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ibrahim Hussein Dabaja, PA-C, PH.D.

  • Medical Physician Assistant
  • Wyandotte, MI
  • NPI 1053592238
  Medicare reassignment NPD Authorized official
• Mohammed Nader Bazzy

  • Family Nurse Practitioner
  • Dearborn Heights, MI
  • NPI 1760070072
  Medicare reassignment NPD
• Fadl A Chokr, M.D.

  • Family Medicine Physician
  • Detroit, MI
  • NPI 1003158171
  Medicare reassignment NPD
• Margaret Craw

  • Physician Assistant
  • Fort Gratiot, MI
  • NPI 1427874403
  Medicare reassignment NPD
• Jennifer Lynn Findlan, DNP, FNP-BC

  • Family Nurse Practitioner
  • Eastpointe, MI
  • NPI 1700582392
  Medicare reassignment NPD
• Joshua Dwaine Lentz, MD

  • Family Medicine Physician
  • Highland, IL
  • NPI 1134781412

  MI

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1756339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769558400000",
    "number": "1013896638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3953 24TH AVE",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480594193",
            "telephone_number": "810-363-9337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3953 24TH AVE",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480594193",
            "telephone_number": "734-299-0712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE WATER PRIMARY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-28",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A",
        "authorized_official_last_name": "DABAJA",
        "authorized_official_first_name": "IBRAHIM",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "810-363-9337",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PA-C, PH.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blue Water Children's Health Care
• Blue Water Family Dentistry PC
• Blue Water Mental Health Clinic (Blue Water Counseling)
• Blue Water Mental Health Clinic
• Blue Water Nursing Center (Evangelical Home - Port Huron)
• Blue Water Serenity Counseling PLLC
• Blue Water Sleep Inc
• Blue Water Urgent Care PLLC
• Blue Water Voice LLC
• Karlene Bognar

• Family Medicine Physician in Fort Gratiot, MI
• Providers in Fort Gratiot, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.