Rubaiya Faruque

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101028118 Issued in MI

Practice address

4190 24TH Ave Ste 208
Fort Gratiot, MI 48059-3884

Phone

(810) 216-4400

NPI assigned

Apr 12, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Family Practice

Education

University of Pikeville, Kentucky College of Osteopathic Med, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Port Huron Physicians Medical Group PCGroup PAC ID 0840507802, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Residential Home Health and Hospice Home health agency, Lapeer, MI, CCN 237495
• Lake Huron Medical Center Hospital, Port Huron, MI, CCN 230031
• McLaren Port Huron Hospital, Port Huron, MI, CCN 230216

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Port Huron Physicians Medical Group PC

  • Family Medicine Physician
  • Fort Gratiot, MI
  • NPI 1598141640
  Medicare reassignment Care Compare group NPD

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

• McLaren Port Huron

  • General Acute Care Hospital
  • Port Huron, MI
  • NPI 1982685384
  Care Compare affiliation
• Prime Healthcare Services-Port Huron LLC

  • General Acute Care Hospital
  • Port Huron, MI
  • NPI 1306227764
  Care Compare affiliation
• Residential Home Health and Hospice, Inc.

  • Home Health Agency
  • Lapeer, MI
  • NPI 1316054810
  Care Compare affiliation
• Residential Home Health and Hospice, Inc.

  • Community Based Hospice Care Agency
  • Lapeer, MI
  • NPI 1831395243

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1618185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1184204281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4190 24TH AVE STE 208",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480593884",
            "telephone_number": "810-216-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4190 24TH AVE STE 208",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480593884",
            "telephone_number": "810-216-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARUQUE",
        "first_name": "RUBAIYA",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-12",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101028118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Evanko, BCBA, LBA
• Sarah L Evans
• Amy Fabick, MSW
• Fahim K Ibrahim M.D., P.C.
• Alicia M Farias
• Kennedy Felax
• Alexa S Fischer
• Samantha May Fitz
• Alexis Folse
• Adrian Shather Forbes, D.D.S.

• Family Medicine Physician in Fort Gratiot, MI
• Providers in Fort Gratiot, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; 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.

Verify at the official NPI Registry.