Deborah Habenicht, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

4301074195 Issued in MI

Practice address

42 North St.Joseph Ave
Suite 300
Niles, MI 49120-2296

Phone

(269) 687-2910

Fax

(269) 687-8770

NPI assigned

Feb 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dhabenicht3012@lakeland.midirect.net

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.

• Lakeland Medical Practices

  dba Corewell Health Medical Group South

  • Internal Medicine Physician
  • Saint Joseph, MI
  • NPI 1538397120
  Medicare reassignment NPD
• Lakeland Medical Practices

  dba Corewell Health Medical Group South

  • Internal Medicine Physician
  • Bridgman, MI
  • NPI 1568232247
  NPD

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

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1467424218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6416 DEANS HILL ROAD",
            "city": "BERRIEN SPRINGS",
            "state": "MI",
            "postal_code": "491209750",
            "telephone_number": "269-471-7741",
            "fax_number": "269-471-1581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 NORTH ST.JOSEPH AVE",
            "address_2": "SUITE 300",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491202296",
            "telephone_number": "269-687-2910",
            "fax_number": "269-687-8770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HABENICHT",
        "first_name": "DEBORAH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-06",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MI",
            "license": "4301074195",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MI",
            "license": "4301074195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0401111441",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "451503610",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Haley Anne Groves, DPT
• Shane Guffey
• Thomas Hadley Gustafson, DPT
• Edmund Curtin Guyer, D.D.S., M.S.
• Elizabeth Ann Habben
• Laurence Habenicht, M.D.
• Haelan Counseling Center
• Amanda Marie Haines
• Eunice Hamilton, RN, FNP-BC
• Maurice D Hampton, LLMSW

• Otolaryngology Physician in Niles, MI
• Providers in Niles, MI by specialty
• Otolaryngology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.