NPIMap

Individual provider Active NPI

Madonna Fabian

  • Internal Medicine Physician
  • St Joseph, MI
National Provider Identifier
1124438411
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301501470 Issued in MI
Practice address
3078 Niles Road
St Joseph, MI 49085-8608
Phone
(269) 287-3949
Fax
(269) 408-8631
NPI assigned
May 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036143635 IL
Hospitalist Physician 208M00000X 036.143635 IL
Internal Medicine Physician 207R00000X 4301501470 MI Primary

Addresses

Primary practice location

3078 Niles Road
St Joseph, MI 49085-8608

Mailing address

3078 Niles Road
St Joseph, MI 49085-8608
Phone (323) 547-2155

Other names 1

  • Dr. Madonna Fabian Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, TN, MI, IN4 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20170811001996 IL Practitioner - HospitalistPractitioner - Internal Medicine 9931470754 Reassigns benefits to 1 organization
I20180619002215 TN Practitioner - Hospitalist 9931470754 Reassigns benefits to 1 organization
I20210609000606 MI Practitioner - Internal Medicine 9931470754 Reassigns benefits to 4 organizations
I20221021002194 IN Practitioner - Internal Medicine 9931470754 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036143635ILMDInternal Medicine Physician
036.143635ILMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rappha Medical Center, P.L.L.C. Internal Medicine CurrentSince Jun 10, 2022 Accepting new patients
Endeavor Health Medical Group CurrentSince Jun 25, 2019 Accepting new patients
Hospitalist Medicine Physicians of Indiana, LLC Internal Medicine CurrentSince Jul 21, 2022 Accepting new patients
Madonna Fabian MD PC Internal Medicine CurrentSince May 24, 2021 Accepting new patients
Hospitalist Medicine Physicians of Michigan, PLLC Internal Medicine CurrentSince Oct 15, 2022 Accepting new patients
Hospitalist Medicine Physicians of Michigan PLLC Internal Medicine CurrentSince Oct 15, 2022 Accepting new patients
Apogee Medical Group Tennessee PC Internal Medicine CurrentSince Dec 19, 2017 Accepting new patients
Endeavor Health Medical Group Internal Medicine Current Accepting new patients
Lakeland Medical Practices Internal Medicine PastSince Jun 10, 2022 Accepting new patients
Ascension Borgess Lee Hospital Past Accepting new patients
Ascension Borgess Hospital Past Accepting new patients

Locations

15059 N Scottsdale Rd
Ste 600
Scottsdale, AZ 85254
Phone (602) 778-3601

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

1666 Checker Rd
Long Grove, IL 60047
Phone (847) 419-1111

601 W 2nd St
Bloomington, IN 47403
Phone (812) 353-5252

1 Atkinson Dr
Ludington, MI 49431
Phone (231) 843-2591

3078 Niles Rd
Saint Joseph, MI 49085
Phone (269) 428-4620

3911 Stonegate Park
Saint Joseph, MI 49085
Phone (269) 408-1777

120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040

1607 S Locust Ave
Lawrenceburg, TN 38464
Phone (731) 287-2244

Interoperability endpoints

  • Direct secure messaging: mfabian@mfmp-mi.direct.office.nextgen.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
  • Direct secure messaging: dr_madonna_fabian@yourcarecommunity.org

Organizations & group practices 12

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 8

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

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sound Inpatient Physicians-Michigan PLLC 168 clinicians

Practice addresses (Care Compare)

3078 Niles Rd
Saint Joseph, MI 49085-8608
Phone (323) 547-2155

420 W Hight St
Borgess Lee Memorial Hospital
Dowagiac, MI 49047-8407
Phone (269) 782-8681

Hospital & facility affiliations

  • Borgess Medical Center Hospital, Kalamazoo, MI, CCN 230117
  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Ascension Borgess Lee Hospital Hospital, Dowagiac, MI, CCN 231315
  • Lakeland Hospital, St Joseph Hospital, St Joseph, MI, CCN 230021
  • Memorial Hospital of South Bend Hospital, South Bend, IN, CCN 150058
  • Ascension Borgess Lee Hospital Nursing home, CCN 23Z315

NPI Registry JSON

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

{
    "created_epoch": "1399420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1124438411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3078 NILES ROAD",
            "city": "ST JOSEPH",
            "state": "MI",
            "postal_code": "490858608",
            "telephone_number": "323-547-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3078 NILES ROAD",
            "city": "ST JOSEPH",
            "state": "MI",
            "postal_code": "490858608",
            "telephone_number": "269-287-3949",
            "fax_number": "269-408-8631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FABIAN",
        "first_name": "MADONNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-07",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036143635",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036.143635",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301501470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MADONNA",
            "last_name": "FABIAN",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in St Joseph, MI

Sources for this page

Verify at the official NPI Registry.