Individual provider Active NPI

Guillermina Nava, MD

  • Plastic Surgery Physician
  • Detroit, MI
National Provider Identifier
1164631024
Registry record updated Sep 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
4301093488 Issued in MI
Practice address
4160 John R St
Suite 615
Detroit, MI 48201-2020
Phone
(313) 745-4195
Fax
(313) 993-8669
NPI assigned
May 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 35-089408 OH
Plastic Surgery Physician 208200000X 4301093488 MI Primary

Addresses

Primary practice location

4160 John R St
Suite 615
Detroit, MI 48201-2020

Mailing address

1560 E Maple Rd
Suite 400 - Credentialing
Troy, MI 48083-1189
Phone (248) 581-5974

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
I20090116000457 MI Practitioner - Plastic and Reconstructive Surgery 6709977275 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
University of Rochester School of Medicine and Dentistry, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Physician GroupGroup PAC ID 8628087681, 399 clinicians

Practice addresses (Care Compare)

1560 E Maple Rd
Troy, MI 48083-1135
Phone (248) 581-5200

Hospital & facility affiliations

  • Karmanos Cancer Center Hospital, Detroit, MI, CCN 230297
  • Harper University Hospital Hospital, Detroit, MI, CCN 230104

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301093488MIMDPlastic Surgery Physician
35-089408OHMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Group CurrentSince Jan 1, 2009 Accepting new patients
University Physician Group CurrentSince Jan 1, 2009 Accepting new patients
University Physician Group Past Accepting new patients

Locations

4160 John R St
Ste 615
Detroit, MI 48201
Phone (313) 745-5111

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

3990 John R St
Ofc
Detroit, MI 48201

4100 John R St
Detroit, MI 48201
Phone (313) 576-8530

1560 E Maple Rd
Ste 400
Troy, MI 48083

1560 E Maple Rd
Ste 200
Troy, MI 48083
Phone (248) 581-5200

Interoperability endpoints

  • Direct secure messaging: gnava@direct.dmc.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 2

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": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443484800000",
    "number": "1164631024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 E MAPLE RD",
            "address_2": "SUITE 400 - CREDENTIALING",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831189",
            "telephone_number": "248-581-5974",
            "fax_number": "248-581-5640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 JOHN R ST",
            "address_2": "SUITE 615",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012020",
            "telephone_number": "313-745-4195",
            "fax_number": "313-993-8669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAVA",
        "first_name": "GUILLERMINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2015-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "OH",
            "license": "35-089408",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MI",
            "license": "4301093488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.