Individual provider Active NPI

Maegan Fabiano

  • Nurse Practitioner
  • Novi, MI
National Provider Identifier
1346876950
Registry record updated Apr 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704273975 Issued in MI
Practice address
39465 W 14 Mile Rd
Novi, MI 48377-1600
Phone
(877) 906-9699
NPI assigned
Mar 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704273975 MI
Nurse Practitioner 363L00000X 4704273975 MI Primary

Addresses

Primary practice location

39465 W 14 Mile Rd
Novi, MI 48377-1600

Mailing address

39465 W 14 Mile Rd
Novi, MI 48377-1600
Phone (877) 906-9699

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200504000471 MI Practitioner - Nurse Practitioner 0446681670 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704273975MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC Nurse Practitioner CurrentSince Aug 15, 2024 Accepting new patients

Locations

13 N Washington St
Ypsilanti, MI 48197
Phone (734) 329-4620

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1584144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680825600000",
    "number": "1346876950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39465 W 14 MILE RD",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483771600",
            "telephone_number": "877-906-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39465 W 14 MILE RD",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483771600",
            "telephone_number": "877-906-9699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FABIANO",
        "first_name": "MAEGAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-14",
        "last_updated": "2023-04-07",
        "certification_date": "2023-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704273975",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704273975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

Verify at the official NPI Registry.