NPIMap

Individual provider Active NPI

Nancy Carbajo, M.D.

  • Internal Medicine Physician
  • Hamburg, MI
National Provider Identifier
1417017187
Registry record updated Jan 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301070176 Issued in MI
Practice address
10020 Professional Center Dr., Suite 120
Hamburg, MI 48139-0799
Phone
(810) 231-0252
Fax
(810) 231-0256
NPI assigned
Dec 11, 2006
Last updated
Jan 7, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2009

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 4301070176 MI Primary

Addresses

Primary practice location

10020 Professional Center Dr., Suite 120
Hamburg, MI 48139-0799

Mailing address

10020 Professional Center Dr., Suite 120
PO Box 799
Hamburg, MI 48139-0799
Phone (810) 231-0252

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040220000583 MI Practitioner - Internal Medicine 0143115840 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Wayne State University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

1255 E M
Pinckney, MI 48169-8133
Phone (734) 878-1000

20555 Victor Pkwy
Livonia, MI 48152-7031

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301070176MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Health Services Corporation Current Accepting new patients
Iha Health Services Corporation Internal Medicine CurrentSince Oct 1, 2012 Accepting new patients
Iha Health Service Corporation CurrentSince Oct 1, 2012 Accepting new patients
Iha Health Services Corporation Past Accepting new patients

Locations

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

10020 Professional Centre Dr
Ste 120
Hamburg Twp, MI 48189
Phone (810) 231-0252

620 Byron Rd
Howell, MI 48843
Phone (517) 545-5450

820 Byron Rd
Ste 200
Howell, MI 48843
Phone (517) 548-1246

1255 E M 36
Pinckney, MI 48169
Phone (734) 878-1000

5325 Elliott Dr
Ste 203
Ypsilanti, MI 48197
Phone (734) 712-8020

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231286400000",
    "number": "1417017187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10020 PROFESSIONAL CENTER DR., SUITE 120",
            "address_2": "PO BOX 799",
            "city": "HAMBURG",
            "state": "MI",
            "postal_code": "481390799",
            "telephone_number": "810-231-0252",
            "fax_number": "810-231-0256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10020 PROFESSIONAL CENTER DR., SUITE 120",
            "city": "HAMBURG",
            "state": "MI",
            "postal_code": "481390799",
            "telephone_number": "810-231-0252",
            "fax_number": "810-231-0256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARBAJO",
        "first_name": "NANCY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2009-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301070176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamburg, MI

Sources for this page

Verify at the official NPI Registry.