Elias G Gennaoui, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

4301037248 Issued in MI

Practice address

14825 Southfield Rd
Allen Park, MI 48101-2642

Phone

(313) 386-3930

Fax

(313) 386-0962

NPI assigned

Jan 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Obhg Michigan, PC

  • Obstetrics & Gynecology Physician
  • Jackson, MI
  • NPI 1790120863
  Medicare reassignment NPD
• Oakwood Healthcare, Inc.

  • General Acute Care Hospital
  • Trenton, MI
  • NPI 1740230648
  NPD (past)

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1316917917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28011 HICKORY DR",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483312952",
            "telephone_number": "248-489-8177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14825 SOUTHFIELD RD",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "481012642",
            "telephone_number": "313-386-3930",
            "fax_number": "313-386-0962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENNAOUI",
        "first_name": "ELIAS",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "4301037248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3442150",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristie Marie Gasiorek, OTR
• Louis Joseph Gaty IV
• Joseph Gayatao, PT
• Erica Renee Geml, DC
• Martha Ellen Genig
• Bruno Gervasi, DPT
• Get a Life Therapy, LLC
• Hiral Paresh Gheewala
• Tiffany Gibson
• Carli Gilliam-Wood, QIDP

• Obstetrics & Gynecology Physician in Allen Park, MI
• Providers in Allen Park, MI by specialty
• Obstetrics & Gynecology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.