Active NPI
Dominic Ondieki Abuya, FNP-BC
- Family Nurse Practitioner
- Grand Rapids, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 4704301890
- Practice address
- 145 Michigan St NE Ste 3410
Grand Rapids, MI 49503-2563 - Phone
- (616) 391-9945
- NPI assigned
- Jul 21, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4704301890 | MI | Primary |
Addresses
Primary practice location
145 Michigan St NE Ste 3410
Grand Rapids, MI 49503-2563
Mailing address
100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | dabuya176416@epic00.shdirect.org | ||
| FHIR URL | https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/ |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
200 Roosevelt Ave E
Battle Creek, MI 49037-2829
Phone (248) 660-1220
850 Phillips St
South Haven, MI 49090-1845
Phone (269) 637-5147
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704301890 | MI | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spectrum Health Primary Care Partners | Current | Accepting new patients | |
| Michigan Family Medicine and Urgent Care | Current | Accepting new patients | |
| Spectrum Health Primary Care Partners | Current | Accepting new patients | |
| Complexcare Medical Group Midwest H PLLC | Current | Accepting new patients |
Locations
200 Roosevelt Ave E
Battle Creek, MI 49037
Phone (269) 965-3327
6700 W Outer Dr
Detroit, MI 48235
Phone (313) 836-1700
100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242
145 Michigan St NE
Ste 3410
Grand Rapids, MI 49503
Phone (616) 391-9945
6531 W Michigan Ave
#C
Jackson, MI 49201
Phone (517) 750-3822
4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600
41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763
850 Phillips St
South Haven, MI 49090
Phone (269) 637-5147
425 E Elm St
Wayland, MI 49348
Phone (269) 792-2249
Interoperability endpoints
- dabuya176416@epic00.corewelldirect.org
- dabuya176416@epic00.shdirect.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.
-
- Internal Medicine Physician
- Novi, MI
- NPI 1457144933
-
- Internal Medicine Physician
- Novi, MI
- NPI 1609362375
-
- Family Medicine Physician
- Dewitt, MI
- NPI 1497225403
-
- Internal Medicine Physician
- Grand Rapids, MI
- NPI 1235188673
-
- Internal Medicine Physician
- Grand Rapids, MI
- NPI 1689499667
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638489600000",
"number": "1053984609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 MICHIGAN ST NE # MC845",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495032560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "145 MICHIGAN ST NE STE 3410",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495032563",
"telephone_number": "616-391-9945"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABUYA",
"first_name": "DOMINIC",
"middle_name": "ONDIEKI",
"name_prefix": "Mr.",
"credential": "FNP-BC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-07-21",
"last_updated": "2021-12-03",
"certification_date": "2021-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MI",
"license": "4704301890",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "dabuya176416@epic00.shdirect.org",
"affiliation": "N",
"address_1": "145 Michigan St NE Ste 3410",
"city": "Grand Rapids",
"state": "MI",
"country_code": "US",
"postal_code": "495032563",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "145 Michigan St NE Ste 3410",
"city": "Grand Rapids",
"state": "MI",
"country_code": "US",
"postal_code": "495032563",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.