Daniel B Azabache, MD
Individual provider Active NPI Nephrology Physician · Oscoda, MI
NPI 1477535193 · NPPES record last updated Feb 26, 2015
Key facts
- NPI
- 1477535193
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nephrology Physician 207RN0300X
- License
- 4301084673 (MI)
- Practice address
- 5671 N Skeel Ave
Oscoda, MI 48750-1535 - Phone
- (989) 739-2550
- Fax
- (989) 358-3750
- NPI assigned
- Nov 17, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 6
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MI, NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041112000231 | MI | Practitioner - Nephrology |
3870557614 | Reassigns benefits to 1 organization |
| I20140924001936 | NY | Practitioner - Internal Medicine |
3870557614 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sound Inpatient Physicians - Michigan, PLLC | Current |
Accepting new patients | |
| Sound Inpatient Physicians-Michigan, PLLC | Current |
Accepting new patients | |
| Alcona Citizens for Health, Inc. | Current | Accepting new patients | |
| Union Community Health Center, Inc. | Current |
Accepting new patients | |
| Gulf Coast Nephrology Associates | Nephrology | Past |
Accepting new patients |
| Mid-South Nephrology Consultants PLLC | Nephrology | Past | Accepting new patients |
Locations
1100 E Michigan Ave
Grayling, MI 49738
Phone (989) 348-0317
1521 Gull Rd
Kalamazoo, MI 49048
Phone (269) 226-5165
580 W College Ave
Marquette, MI 49855
Phone (906) 225-3131
260 E 188th St
Bronx, NY 10458
Phone (718) 618-8236
2021 Grand Concourse
Bronx, NY 10453
Phone (718) 299-2800
Interoperability endpoints
- danielazabache-mmacfh@direct.medalliesmail.com
- dazabache3675302@direct.trinity-health.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 4301084673 | MI | Yes |
Addresses
Primary practice location
5671 N Skeel Ave
Oscoda, MI 48750-1535
Mailing address
5671 N Skeel Ave
Oscoda, MI 48750-1535
Phone (989) 739-2550
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4914101 | Medicaid | MI | |
| DA084673 | Other | MI | BC-BS |
Other providers in Oscoda, MI
- Alcona Citizens for Health Inc
- Alcona Citizens for Health, Inc.
- Alcona Citizens for Health, Inc.
- Leah Marie Allen
- Amanda Joann Aube
- Tammy Rose Baldwin
- Nathan D. Barden
- Kaleb M Barnes
- Andrew Beardsley
- Lydia Beardsley
All providers in Oscoda, MI · Nephrology Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 26, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.