Lidiya Ayele Biltibo, M.D.

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

4351048229 Issued in MI

Practice address

DMC Sinai Grace Hospital
4201 St Antoine
Detroit, MI 48201

Phone

(416) 848-6240

NPI assigned

Jun 10, 2021

Reactivated

Sep 29, 2021

Last updated

Sep 29, 2021By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1623283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1477120079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1824 KIRTS BLVD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "48084",
            "telephone_number": "240-310-5014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DMC SINAI GRACE HOSPITAL",
            "address_2": "4201 ST ANTOINE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48201",
            "telephone_number": "416-848-6240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BILTIBO",
        "first_name": "LIDIYA",
        "middle_name": "AYELE",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-10",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "deactivation_date": "2021-08-30",
        "reactivation_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4351048229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Allen Billy Jr.
• Demetra Billy
• Rhondia Elaine Billy
• Wayne Billy Sr.
• Juliana Bilowus, DO
• Susan Ellen Binder-Demott, MA, LLP
• Maliyan Binette
• Andrew Bingmon, LMSW
• Kim C Binion Richards, RPH, MBA
• Lisa Binns-Emerick, CNP, GCNS-BC

• Student in an Organized Health Care Education/Training Program in Detroit, MI
• Providers in Detroit, MI by specialty
• Student in an Organized Health Care Education/Training Program in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.