Maureen Ziboh, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01045545A Issued in IN

Practice address

69045 M 62 Ste B
Edwardsburg, MI 49112-9168

Phone

(574) 968-4100

Fax

(574) 968-4125

NPI assigned

Jun 26, 2006

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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IN, MI2 enrollments

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 2

Specialty

Family Practice

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Theoria MedicalGroup PAC ID 5395098339, 317 clinicians

Avenue Hematology and Oncology LLCGroup PAC ID 4082864921, 2 clinicians

Complexcare Medical Group Midwest H PLLCGroup PAC ID 0143737148, 128 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Gentiva II Hospice, Portage, MI, CCN 231591
• Lakeland Hospital, St Joseph Hospital, St Joseph, MI, CCN 230021
• Memorial Hospital of South Bend Hospital, South Bend, IN, CCN 150058
• Community Hospital of Bremen Inc Hospital, Bremen, IN, CCN 151300
• Brickyard Healthcare - Fountainview Care Center Nursing home, Mishawaka, IN, CCN 155178
• The Orchards at Niles Nursing home, Niles, MI, CCN 235598
• Brickyard Healthcare - Twelfth Street Care Center Nursing home, Mishawaka, IN, CCN 155109

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Riveridge Mi Opco LLC

  • Skilled Nursing Facility
  • Niles, MI
  • NPI 1023985561

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

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.

• Complexcare Medical Group Midwest H PLLC

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1457144933

  IN

  Medicare reassignment Care Compare group NPD
• Theoria Medical

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1609362375

  IN

  Medicare reassignment Care Compare group NPD
• Avenue Hematology and Oncology LLC

  • Medical Specialty Clinic/Center
  • South Bend, IN
  • NPI 1942559380

  MI

  Medicare reassignment Care Compare group NPD
• Allied Family Medicine

  • Family Medicine Physician
  • Mishawaka, IN
  • NPI 1184651499
  NPD (past) Authorized official
• Ardan Associates, Inc

  • Skilled Nursing Facility
  • Niles, MI
  • NPI 1538167267
  NPD (past)
• Niles Mi Opco LLC

  • Skilled Nursing Facility
  • Niles, MI
  • NPI 1659996973
  NPD (past)
• Riveridge Mi Opco LLC

  • Skilled Nursing Facility
  • Niles, MI
  • NPI 1023985561
  NPD (past)

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

• Lakeland Hospitals at Niles and St Joseph, Inc

  • General Acute Care Hospital
  • Saint Joseph, MI
  • NPI 1134220031
  Care Compare affiliation
• Riveridge Mi Opco LLC

  • Skilled Nursing Facility
  • Niles, MI
  • NPI 1023985561

  Nursing home

  Care Compare affiliation
• Southerncare, Inc.

  • Community Based Hospice Care Agency
  • Portage, MI
  • NPI 1114965688
  Care Compare affiliation
• Community Hospital of Bremen, Inc

  • Critical Access Hospital
  • Bremen, IN
  • NPI 1568417004
  Care Compare affiliation
• Hendricks County Hospital

  • Skilled Nursing Facility
  • Mishawaka, IN
  • NPI 1669650297

  Nursing home

  Care Compare affiliation
• Hendricks County Hospital

  • Skilled Nursing Facility
  • Mishawaka, IN
  • NPI 1851579486

  Nursing home

  Care Compare affiliation
• Memorial Hospital of South Bend

  • General Acute Care Hospital
  • South Bend, IN
  • NPI 1295772093
  Care Compare affiliation
• Memorial Hospital of South Bend

  • Psychiatric Hospital Unit
  • South Bend, IN
  • NPI 1376841395
  Care Compare affiliation
• Memorial Hospital of South Bend

  • General Acute Care Hospital
  • Granger, IN
  • NPI 1881177756
  Care Compare affiliation

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539129600000",
    "number": "1275560583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69045 M 62 STE B",
            "city": "EDWARDSBURG",
            "state": "MI",
            "postal_code": "491129168",
            "telephone_number": "574-968-4100",
            "fax_number": "574-968-4125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69045 M 62 STE B",
            "city": "EDWARDSBURG",
            "state": "MI",
            "postal_code": "491129168",
            "telephone_number": "574-968-4100",
            "fax_number": "574-968-4125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIBOH",
        "first_name": "MAUREEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-26",
        "last_updated": "2018-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01045545A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200046830A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000532035",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200046830",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aranella Dionisio Villaluz, PT, PTA, MOH
• Von Carlo Viaje Villaluz, PT
• Corrina Weihrauch, DC
• Cynthia Jean Werner
• Debra E White

• Family Medicine Physician in Edwardsburg, MI
• Providers in Edwardsburg, 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 Oct 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.