Elzbieta Wieslawa Baba, DNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704294575 Issued in MI

Practice address

15450 Northline Rd. Suite 101
Southgate, MI 48195-7952

Phone

(734) 225-1315

Fax

(877) 892-4080

NPI assigned

Aug 30, 2017

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: ebaba790545@direct.hfhs.org

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

{
    "created_epoch": "1504051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1255859195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14600 KING RD # A",
            "city": "RIVERVIEW",
            "state": "MI",
            "postal_code": "481937952",
            "telephone_number": "734-479-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15450 NORTHLINE RD. SUITE 101",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481957952",
            "telephone_number": "734-225-1315",
            "fax_number": "877-892-4080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BABA",
        "first_name": "ELZBIETA",
        "middle_name": "WIESLAWA",
        "name_prefix": "Mrs.",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-30",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704294575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracy Lynette Austin, LLMSW, SST
• Eduardo Avena
• Axiom Hospice LLC
• Emmanuel Ayala
• Gladys Marie Ayala, M.T
• Erika Bacha
• Michelle M Backus-Porter
• Shawna Bailey
• Brooklyn Bain
• Chrystal Baker, B.S. LSST

• Family Nurse Practitioner in Southgate, MI
• Providers in Southgate, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.