Individual provider Active NPI

Nibal A Eid, MD

  • Pediatrics Physician
  • Flint, MI
National Provider Identifier
1053870014
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301507036 Issued in MI
Practice address
1 Hurley PLZ
Flint, MI 48503-5902
Phone
(810) 262-9000
NPI assigned
Mar 18, 2019
Last updated
Nov 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301507036 MI Primary

Addresses

Primary practice location

1 Hurley PLZ
Flint, MI 48503-5902

Mailing address

1 Hurley PLZ
Flint, MI 48503-5902
Phone (810) 262-9000

Other practice location 1

1250 E Michigan Ave Ste C
Grayling, MI 49738-7074
Phone (989) 348-0550

Other practice location 2

400 Hobart St
Cadillac, MI 49601-2331
Phone (231) 876-7200

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
I20240814004553 MI Practitioner - Pediatric Medicine 1759829211 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Healthcare Grayling CurrentSince Aug 24, 2024 Accepting new patients
Munson Healthcare Grayling Current Accepting new patients

Locations

3781 Momentum Pl
Chicago, IL 60689

1250 E Michigan Ave
Grayling, MI 49738
Phone (989) 348-0550

1250 E Michigan Ave
Ste C
Grayling, MI 49738
Phone (989) 348-0550

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1053870014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HURLEY PLZ",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485035902",
            "telephone_number": "810-262-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HURLEY PLZ",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485035902",
            "telephone_number": "810-262-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 E Michigan Ave Ste C",
            "address_purpose": "LOCATION",
            "city": "Grayling",
            "state": "MI",
            "postal_code": "497387074",
            "country_code": "US",
            "telephone_number": "989-348-0550",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 Hobart St",
            "address_purpose": "LOCATION",
            "city": "Cadillac",
            "state": "MI",
            "postal_code": "496012331",
            "country_code": "US",
            "telephone_number": "231-876-7200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EID",
        "first_name": "NIBAL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-18",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301507036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.