Individual provider Active NPI

Harman Fervaha, M.D.

  • Rheumatology Physician
  • Saint Joseph, MI
National Provider Identifier
1255719696
Registry record updated Dec 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
4301501987 Issued in MI
Practice address
3950 Hollywood Rd Ste 288
Saint Joseph, MI 49085-9159
Phone
(269) 408-0990
NPI assigned
May 18, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 309401 LA
Student in an Organized Health Care Education/Training Program 390200000X LA
Student in an Organized Health Care Education/Training Program 390200000X
Rheumatology Physician 207RR0500X 4301501987 MI Primary

Addresses

Primary practice location

3950 Hollywood Rd Ste 288
Saint Joseph, MI 49085-9159

Mailing address

3950 Hollywood Rd Ste 288
Saint Joseph, MI 49085-9159
Phone (269) 408-0990

Other practice location 1

1978 Industrial Blvd
Houma, LA 70363
Phone (985) 873-2200

Other practice location 2

1978 Industrial Blvd
Houma, LA 70363
Phone (985) 873-2200

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL EPIC

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
I20201210001360 MI Practitioner - Rheumatology 3870882566 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lakeland Medical PracticesGroup PAC ID 1658427042, 286 clinicians

Practice addresses (Care Compare)

3950 Hollywood Rd
Saint Joseph, MI 49085-9151
Phone (269) 408-0990

Hospital & facility affiliations

  • Lakeland Hospital, St Joseph Hospital, St Joseph, MI, CCN 230021
  • Corewell Health Watervliet Hospital Hospital, Watervliet, MI, CCN 230078

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
309401LAMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Hospitals at Niles and St Joseph, Inc CurrentSince May 11, 2024 Accepting new patients
Lakeland Medical Practices Internal Medicine CurrentSince Sep 14, 2020 Accepting new patients
Lakeland Hospitals at Niles and St Joseph, Inc CurrentSince May 11, 2024 Accepting new patients
Lakeland Medical Practices Internal Medicine CurrentSince Sep 14, 2020 Accepting new patients

Locations

3950 Hollywood Rd
Ste 288
Saint Joseph, MI 49085
Phone (269) 408-0990

3950 Hollywood Rd
Ste 280
Saint Joseph, MI 49085
Phone (269) 408-0990

1234 Napier Ave
Saint Joseph, MI 49085
Phone (269) 982-4941

Interoperability endpoints

  • Direct secure messaging: hfervaha1269422@epic00.corewelldirect.org

Organizations & group practices 4

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": "1431907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1255719696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 HOLLYWOOD RD STE 288",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859159",
            "telephone_number": "269-408-0990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 HOLLYWOOD RD STE 288",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859159",
            "telephone_number": "269-408-0990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1978 Industrial Blvd",
            "address_purpose": "LOCATION",
            "city": "Houma",
            "state": "LA",
            "postal_code": "70363",
            "country_code": "US",
            "telephone_number": "985-873-2200",
            "fax_number": "985-873-1374",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1978 Industrial Blvd",
            "address_purpose": "LOCATION",
            "city": "Houma",
            "state": "LA",
            "postal_code": "70363",
            "country_code": "US",
            "telephone_number": "985-873-2200",
            "fax_number": "985-873-1374",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERVAHA",
        "first_name": "HARMAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-18",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "LA",
            "license": "309401",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "LA",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MI",
            "license": "4301501987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "EPIC",
            "affiliation": "N",
            "address_1": "3950 Hollywood Rd Ste 288",
            "city": "Saint Joseph",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490859159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Joseph, MI

Sources for this page

Verify at the official NPI Registry.