Individual provider Active NPI

Nelia Maria Afonso, MD

  • Internal Medicine Physician
  • Detroit, MI
National Provider Identifier
1477590073
Registry record updated Oct 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301055075 Issued in MI
Practice address
4201 Saint Antoine St
Suite 5a
Detroit, MI 48201-2153
Phone
(313) 745-4525
NPI assigned
Jun 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301055075 MI Primary

Addresses

Primary practice location

4201 Saint Antoine St
Suite 5a
Detroit, MI 48201-2153

Mailing address

3800 Woodward Ave
Suite 702
Detroit, MI 48201-2061

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nafonso48234@direct.beaumont.edu

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040706001093 MI Practitioner - Internal Medicine 6901883115 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oakwood Ambulatory LLCGroup PAC ID 1850282914, 271 clinicians

Practice addresses (Care Compare)

1949 W 12 Mile Rd
100 Corewell Health William Beaumont Un
Berkley, MI 48072-1868
Phone (248) 551-0615

201 3Rd St
Suite 200
Belleville, MI 48111-2605
Phone (734) 697-9065

Hospital & facility affiliations

  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301055075MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oakwood Ambulatory LLC Internal Medicine CurrentSince Jun 25, 2018 Accepting new patients
Oakwood Ambulatory, LLC CurrentSince Jun 25, 2018 Accepting new patients
University Physician Group Internal Medicine Past Accepting new patients

Locations

201 3rd St
Ste 200
Belleville, MI 48111
Phone (734) 697-9065

1949 W 12 Mile Rd
Ste 100
Berkley, MI 48072
Phone (248) 551-0615

3601 W 13 Mile Rd
Royal Oak, MI 48073

3535 W 13 Mile Rd
Royal Oak, MI 48073
Phone (248) 551-1010

Interoperability endpoints

  • Direct secure messaging: nafonso48234@direct.beaumont.edu

Organizations & group practices 3

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 3

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": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1477590073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 WOODWARD AVE",
            "address_2": "SUITE 702",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 SAINT ANTOINE ST",
            "address_2": "SUITE 5A",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "313-745-4525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AFONSO",
        "first_name": "NELIA",
        "middle_name": "MARIA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-01",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301055075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nafonso48234@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "4201 Saint Antoine St",
            "address_2": "Suite 5A",
            "city": "Detroit",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482012153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.