Delta Renal Group, P.C.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

4301072901 Issued in MI

Legal business name

DELTA RENAL GROUP, P.C.

Doing business as

Boniface Tubie, M.D.

Practice address

20755 Greenfield Rd
Suite Number 203
Southfield, MI 48075-5403

Phone

(248) 395-2206

Fax

(248) 395-0456

NPI assigned

Aug 2, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Boniface Atakekor Tubie, M.D.NPI 1821144577

Title

President/ Coe

Phone

(248) 395-2206

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Boniface Tubie, M.D. Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Riverview Lifeline Center PLLC

  • Specialist
  • Detroit, MI
  • NPI 1528130325

  Member Of

  NPD member

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CGIEBA

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Delphi Dialysis Corporation

  • Nephrology Physician
  • Southfield, MI
  • NPI 1821740465
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Boniface Atakekor Tubie, M.D.

  • Nephrology Physician
  • Southfield, MI
  • NPI 1821144577
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407863194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20755 GREENFIELD RD",
            "address_2": "SUITE NUMBER 203",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480755403",
            "telephone_number": "248-395-2206",
            "fax_number": "248-395-0456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20755 GREENFIELD RD",
            "address_2": "SUITE NUMBER 203",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480755403",
            "telephone_number": "248-395-2206",
            "fax_number": "248-395-0456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELTA RENAL GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TUBIE",
        "authorized_official_first_name": "BONIFACE",
        "authorized_official_middle_name": "ATAKEKOR",
        "authorized_official_title_or_position": "PRESIDENT/ COE",
        "authorized_official_telephone_number": "248-395-2206",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "MI",
            "license": "4301072901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4341231",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boniface Tubie, M.D.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Benjamin Delaney, PMHNP-BC
• Carson Delany
• Myrna S Deleon, MD
• Delphi Dialysis Corporation
• Delta Home Health Care LLC
• Que K Deluna, RPH
• Deluxe Dental Associates 6 Southfield PLLC (Deluxe Dental)
• Madison Delvaux
• Megan Virginia Demallie
• Frances Claire Demattia, DO

• Nephrology Physician in Southfield, MI
• Providers in Southfield, MI by specialty
• Nephrology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.