Individual provider Active NPI

Alexandrea Jade Garbus, CNM

  • Advanced Practice Midwife
  • Detroit, MI
National Provider Identifier
1205359106
Registry record updated Feb 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
CNM04202 Issued in MI
Practice address
4229 Cass Ave
Detroit, MI 48201-1709
Phone
(313) 831-7776
Fax
(734) 926-8987
NPI assigned
Jul 23, 2017
Last updated
Feb 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X CNM04202 MI Primary

Addresses

Primary practice location

4229 Cass Ave
Detroit, MI 48201-1709

Mailing address

2260 Ellwood Ave
Berkley, MI 48072-3204
Phone (313) 330-4013

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220927003728 MI Practitioner - Certified Nurse Midwife (CNM) 4880070929 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
CNM04202MIMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Olma Specialty Services LLC CurrentSince Sep 1, 2022 Accepting new patients
Henry Ford Health System Current Accepting new patients
Iha Olma Specialty Services LLC CurrentSince Sep 1, 2022 Accepting new patients
Henr Y Ford Health System Advanced Practice Midwife CurrentSince Oct 1, 2024 Accepting new patients
Henry Ford Health System CurrentSince Oct 1, 2024 Accepting new patients
Planned Parenthood of Michigan Past Accepting new patients
Henry Ford Health System Past Accepting new patients
Planned Parenthood of West & Northern Michigan, Inc. Past Accepting new patients

Locations

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 647-5871

1750 S Telegraph Rd
Ste 108
Bloomfield Hills, MI 48302
Phone (248) 334-4505

1750 S Telegraph Rd
Ste 108A
Bloomfield Hills, MI 48302
Phone (248) 334-3213

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

1854 W Auburn Rd
Ste 100B
Rochester Hills, MI 48309
Phone (248) 218-9260

6777 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 325-1000

Interoperability endpoints

  • Direct secure messaging: agarbus2062913@direct.trinity-health.org
  • Direct secure messaging: agarbus421157@direct.hfhs.org

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1500768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708646400000",
    "number": "1205359106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2260 ELLWOOD AVE",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480723204",
            "telephone_number": "313-330-4013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4229 CASS AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482011709",
            "telephone_number": "313-831-7776",
            "fax_number": "734-926-8987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARBUS",
        "first_name": "ALEXANDREA",
        "middle_name": "JADE",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-23",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MI",
            "license": "CNM04202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.