Individual provider Active NPI

Prizy Job, M.D.

  • Internal Medicine Physician
  • Dearborn, MI
National Provider Identifier
1366760134
Registry record updated Apr 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301106173 Issued in MI
Practice address
19401 Hubbard Dr
Suite 206
Dearborn, MI 48126-2641
Phone
(313) 982-8305
Fax
(313) 982-8343
NPI assigned
May 4, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301106173 MI Primary

Addresses

Primary practice location

19401 Hubbard Dr
Suite 206
Dearborn, MI 48126-2641

Mailing address

19401 Hubbard Dr
Suite 206
Dearborn, MI 48126-2641
Phone (313) 982-8305

Other identifiers 1

IdentifierTypeStateIssuer
4301106173OtherMILICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pjob362659@direct.hfhs.org

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
I20140819002798 MI Practitioner - Internal Medicine 8123258027 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

19401 Hubbard Dr
Dearborn, MI 48126-2641
Phone (313) 982-8100

Hospital & facility affiliations

  • Henry Ford Home Health Care Home health agency, Detroit, MI, CCN 237087
  • Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053
  • Wyandotte Hospital and Medical Center Hospital, Wyandotte, MI, CCN 230146

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301106173MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Internal Medicine CurrentSince Jul 1, 2015 Accepting new patients
Henry Ford Health System CurrentSince Jul 1, 2015 Accepting new patients
Henry Ford Health System Current Accepting new patients
Henry Ford Maplegrove Center Past Accepting new patients
The Cleveland Clinic Foundation Past Accepting new patients

Locations

19401 Hubbard Dr
Ste 206
Dearborn, MI 48126
Phone (313) 982-4400

19401 Hubbard Dr
Dearborn, MI 48126
Phone (313) 982-8100

6071 W Outer Dr
#7E
Detroit, MI 48235
Phone (313) 966-4797

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

6071 W Outer Dr
Ste 7
Detroit, MI 48235
Phone (313) 966-3300

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

6777 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 325-1000

Organizations & group practices 5

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": "1272931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617235200000",
    "number": "1366760134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19401 HUBBARD DR",
            "address_2": "SUITE 206",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262641",
            "telephone_number": "313-982-8305",
            "fax_number": "313-982-8343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19401 HUBBARD DR",
            "address_2": "SUITE 206",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262641",
            "telephone_number": "313-982-8305",
            "fax_number": "313-982-8343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOB",
        "first_name": "PRIZY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-04",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301106173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "4301106173",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pjob362659@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "2799 W Grand Blvd",
            "city": "Detroit",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482022608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.