Individual provider Active NPI

Lubna Iqbal Fatiwala, MD

  • Internal Medicine Physician
  • Detroit, MI
National Provider Identifier
1275997447
Registry record updated Nov 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301500795 Issued in MI
Practice address
4201 Saint Antoine St # 2E
Detroit, MI 48201-2153
Phone
(313) 745-4832
NPI assigned
Apr 13, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 4301500795 MI Primary

Addresses

Primary practice location

4201 Saint Antoine St # 2E
Detroit, MI 48201-2153

Mailing address

4201 Saint Antoine St Ste 2E
Detroit, MI 48201-2153
Phone (313) 745-4832

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
I20191205001558 MI Practitioner - Internal Medicine 9830480441 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Physician GroupGroup PAC ID 8628087681, 399 clinicians

Practice addresses (Care Compare)

4201 Saint Antoine St
Detroit, MI 48201-2153
Phone (313) 745-4525

Hospital & facility affiliations

  • Detroit Receiving Hospital Hospital, Detroit, MI, CCN 230273
  • Karmanos Cancer Center Hospital, Detroit, MI, CCN 230297
  • Harper University Hospital Hospital, Detroit, MI, CCN 230104
  • Rehabilitation Institute of Michigan Inpatient rehabilitation facility, Detroit, MI, CCN 233027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301500795MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Group Internal Medicine CurrentSince Nov 12, 2019 Accepting new patients
VHS Harper-Hutzel Hospital Inc Past Accepting new patients
VHS Detroit Receiving Hospital Inc Past Accepting new patients
Barbara Ann Karmanos Cancer Hospital Past Accepting new patients

Locations

4201 Saint Antoine St
#5A
Detroit, MI 48201

4201 Saint Antoine St
Ste 2E
Detroit, MI 48201
Phone (313) 265-7525

4201 Saint Antoine St
Detroit, MI 48201
Phone (313) 745-3615

3901 Chrysler Dr
Ste 4A
Detroit, MI 48201
Phone (313) 966-7601

4100 John R St
Detroit, MI 48201
Phone (313) 576-8530

4201 Saint Antoine St
Ste 5A
Detroit, MI 48201
Phone (313) 966-2492

400 Mack Ave
Ste 2E
Detroit, MI 48201

4201 Saint Antoine St
#2E
Detroit, MI 48201
Phone (313) 745-7888

26400 W 12 Mile Rd
Ste 111
Southfield, MI 48034
Phone (248) 357-4151

1560 E Maple Rd
Ste 200
Troy, MI 48083
Phone (248) 581-5200

Interoperability endpoints

  • Direct secure messaging: lubna.fatiwala.1@19711.direct.athenahealth.com
  • Direct secure messaging: lfatiwala941121@direct.hfhs.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 4

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": "1460505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574294400000",
    "number": "1275997447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 SAINT ANTOINE ST STE 2E",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "313-745-4832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 SAINT ANTOINE ST # 2E",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "313-745-4832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FATIWALA",
        "first_name": "LUBNA",
        "middle_name": "IQBAL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-13",
        "last_updated": "2019-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301500795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.