Individual provider Active NPI

Huma Devi Liptak, DO

  • Student in an Organized Health Care Education/Training Program
  • Wyoming, MI
National Provider Identifier
1043065469
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
5151016624 Issued in MI
Practice address
5900 Byron Center Ave SW
Wyoming, MI 49519-9606
Phone
(616) 252-7200
Fax
(616) 252-4953
NPI assigned
Apr 19, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 5151016624 MI Primary

Addresses

Primary practice location

5900 Byron Center Ave SW
Wyoming, MI 49519-9606

Mailing address

5900 Byron Center Ave SW
Wyoming, MI 49519-9606

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
I20240715002117 MI Order and Referring Only - Emergency MedicinePractitioner - Emergency Medicine 5092250092

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1713484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1043065469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 BYRON CENTER AVE SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 BYRON CENTER AVE SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199606",
            "telephone_number": "616-252-7200",
            "fax_number": "616-252-4953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPTAK",
        "first_name": "HUMA",
        "middle_name": "DEVI",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-19",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "5151016624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

Verify at the official NPI Registry.