Organization Active NPI

Nova Medica PLLC

  • Internal Medicine Physician
  • Livonia, MI
National Provider Identifier
1417979360
Registry record updated Jul 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
NT060867 Issued in MI
Legal business name
NOVA MEDICA PLLC
Practice address
20331 Farmington Rd
Livonia, MI 48152-1411
Phone
(248) 478-1100
Fax
(248) 478-7054
NPI assigned
Jul 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2010

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

Authorized official

Name
Dr. Nasser Taghavi, MDNPI 1487624383
Title
Doctor/Owner
Phone
(248) 478-1100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X NT060867 MI Primary

Addresses

Primary practice location

20331 Farmington Rd
Livonia, MI 48152-1411

Mailing address

20331 Farmington Rd
Livonia, MI 48152-1411
Phone (248) 478-1100

Other identifiers 1

IdentifierTypeStateIssuer
4334184MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100719000825 MI Part B Supplier - Clinic/Group Practice 6901938489 Receives reassigned benefits from 6 practitioners
Practice locations: Commerce Township, MI; Livonia, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279238400000",
    "number": "1417979360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20331 FARMINGTON RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481521411",
            "telephone_number": "248-478-1100",
            "fax_number": "248-478-7054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20331 FARMINGTON RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481521411",
            "telephone_number": "248-478-1100",
            "fax_number": "248-478-7054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA MEDICA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-23",
        "last_updated": "2010-07-16",
        "status": "A",
        "authorized_official_last_name": "TAGHAVI",
        "authorized_official_first_name": "NASSER",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "248-478-1100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "NT060867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4334184",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2010; 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.