Individual provider Active NPI

Luma Beydoun, FNP

  • Family Nurse Practitioner
  • Dearborn Heights, MI
National Provider Identifier
1114449295
Registry record updated Nov 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704295099 Issued in MI
Practice address
27155 Cherry Hill Road
Dearborn Heights, MI 48127
Phone
(313) 749-1178
Fax
(313) 733-2029
NPI assigned
Jul 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2021

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 4704295099 MI Primary

Addresses

Primary practice location

27155 Cherry Hill Road
Dearborn Heights, MI 48127

Mailing address

30 W Monroe St FL 12
Chicago, IL 60603-2495
Phone (312) 733-9730

Other identifiers 1

IdentifierTypeStateIssuer
4704295099OtherMIRN LICENSE

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
I20170811000671 MI Practitioner - Nurse Practitioner 9739450636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osh Mi Physicians Group, PCGroup PAC ID 7810282191, 154 clinicians

Practice addresses (Care Compare)

18610 Fenkell St
Detroit, MI 48223-2378
Phone (313) 723-6000

Hospital & facility affiliations

  • Corewell Health Wayne Hospital Hospital, Wayne, MI, CCN 230142

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Osh Mi Physicians Group, PC CurrentSince Aug 7, 2017 Accepting new patients
Osh-Mi Physicians Group PC CurrentSince Aug 7, 2017 Accepting new patients
Osh-Mi Physicians Group PC Family Past Accepting new patients

Locations

18610 Fenkell St
Detroit, MI 48223
Phone (313) 723-6000

27155 Cherry Hill Rd
Inkster, MI 48141
Phone (313) 749-1178

Interoperability endpoints

  • Direct secure messaging: lbeydoun413810@direct.hfhs.org

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1499731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1114449295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 W MONROE ST FL 12",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606032495",
            "telephone_number": "312-733-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27155 CHERRY HILL ROAD",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "48127",
            "telephone_number": "313-749-1178",
            "fax_number": "313-733-2029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEYDOUN",
        "first_name": "LUMA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-11",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704295099",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "4704295099",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn Heights, MI

Sources for this page

Verify at the official NPI Registry.