NPIMap

Individual provider Active NPI

Mountaha Eidy, DO

  • Emergency Medicine Physician
  • Garden City, MI
National Provider Identifier
1437644028
Registry record updated Jan 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
5151009989 Issued in MI
Practice address
6245 Inkster Rd
Garden City, MI 48135-4001
Phone
(734) 458-4486
NPI assigned
Jun 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 5151009989 MI Primary

Addresses

Primary practice location

6245 Inkster Rd
Garden City, MI 48135-4001

Mailing address

6245 Inkster Rd
Garden City, MI 48135-4001

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
I20201130000556 MI Practitioner - Emergency Medicine 2062768922 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Michigan State University College of Osteopathic Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians
Emergency Professionals of Michigan PCGroup PAC ID 3274767371, 49 clinicians
Ihp Mi Emergency Medicine PLLCGroup PAC ID 2365821634, 42 clinicians

Practice addresses (Care Compare)

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600

5450 Fort St
Trenton, MI 48183-4601
Phone (734) 671-3800

6245 Inkster Rd
Garden City, MI 48135-4001
Phone (734) 458-3300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.64 of 100Reported as group
Quality
85.06
Promoting interoperability
100
Improvement activities
40
Cost
77.9

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5151009989MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Emergency Medicine CurrentSince Oct 1, 2024 Accepting new patients
Henry Ford Health System CurrentSince Oct 1, 2024 Accepting new patients
Internal Medicine Solutions PLLC CurrentSince Aug 1, 2021 Accepting new patients
Emergency Professionals of Michigan, P.C. Emergency Medicine CurrentSince Apr 1, 2025 Accepting new patients
Ihp Mi Emergency Medicine PLLC Emergency Medicine CurrentSince Jan 1, 2023 Accepting new patients
Beaumont Medical Group Hospital -Based Services CurrentSince Jan 26, 2022 Accepting new patients
Henry Ford Health System Current Accepting new patients

Locations

7300 N Canton Center Rd
Canton, MI 48187
Phone (734) 454-8001

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

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

6245 Inkster Rd
Garden City, MI 48135
Phone (734) 421-3300

826 W King St
Owosso, MI 48867
Phone (989) 720-2273

2601 Electric Ave
Port Huron, MI 48060
Phone (810) 216-1500

44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255

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

35700 Warren Rd
Westland, MI 48185
Phone (313) 828-5000

5450 Fort St
Woodhaven, MI 48183
Phone (734) 671-3297

Interoperability endpoints

  • Direct secure messaging: meidy1232394@epic00.shdirect.org
  • Direct secure messaging: meidy1054279@direct.hfhs.org
  • Direct secure messaging: meidy388485@direct.hfhs.org

Organizations & group practices 7

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 9

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": "1529971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547596800000",
    "number": "1437644028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6245 INKSTER RD",
            "city": "GARDEN CITY",
            "state": "MI",
            "postal_code": "481354001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6245 INKSTER RD",
            "city": "GARDEN CITY",
            "state": "MI",
            "postal_code": "481354001",
            "telephone_number": "734-458-4486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EIDY",
        "first_name": "MOUNTAHA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-26",
        "last_updated": "2019-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5151009989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, MI

Sources for this page

Verify at the official NPI Registry.