Individual provider Active NPI

Mimoza Zaka, NP

  • Family Nurse Practitioner
  • Rochester Hills, MI
National Provider Identifier
1053786954
Registry record updated Dec 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704270176 Issued in MI
Practice address
289 Essex Dr
Rochester Hills, MI 48307-3508
Phone
(248) 247-6811
NPI assigned
Dec 3, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704270176 MI Primary

Addresses

Primary practice location

289 Essex Dr
Rochester Hills, MI 48307-3508

Mailing address

289 Essex Dr
Rochester Hills, MI 48307-3508
Phone (248) 247-6811

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160307000480 MI Practitioner - Nurse Practitioner 1850697533 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fadi Ibrahim, MD PC CurrentSince Jan 1, 2019 Accepting new patients
Vpa PC CurrentSince Sep 1, 2023 Accepting new patients
Vpa PC Current Accepting new patients
Vpa PC CurrentSince Sep 1, 2023 Accepting new patients

Locations

31313 Northwestern Hwy
Ste 203
Farmington Hills, MI 48334
Phone (248) 880-0123

500 Kirts Blvd
Ste 200
Troy, MI 48084
Phone (248) 824-6060

Interoperability endpoints

  • Direct secure messaging: mzaka853303@direct.hfhs.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1449100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449100800000",
    "number": "1053786954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "289 ESSEX DR",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483073508",
            "telephone_number": "248-247-6811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "289 ESSEX DR",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483073508",
            "telephone_number": "248-247-6811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAKA",
        "first_name": "MIMOZA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-03",
        "last_updated": "2015-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704270176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester Hills, MI

Sources for this page

Verify at the official NPI Registry.