Individual provider Active NPI

Labib Joumaa, MD

  • Student in an Organized Health Care Education/Training Program
  • Port Huron, MI
National Provider Identifier
1497642623
Registry record updated Jun 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
4351054865 Issued in MI
Practice address
1313 Stone St
Port Huron, MI 48060-3520
Phone
(810) 985-2620
NPI assigned
Jun 20, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 4351054865 MI Primary

Addresses

Primary practice location

1313 Stone St
Port Huron, MI 48060-3520

Mailing address

1313 Stone St
Port Huron, MI 48060-3520

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
I20250707003179 MI Order and Referring Only - Family PracticePractitioner - Family Practice 6103330790

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4351054865MIMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Water OB & GYN PC CurrentSince Jun 23, 2025 Accepting new patients
McLaren Port Huron PastSince Jun 23, 2025 Accepting new patients

Locations

1313 Stone St
Port Huron, MI 48060
Phone (810) 984-3181

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1750377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750377600000",
    "number": "1497642623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 STONE ST",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 STONE ST",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603520",
            "telephone_number": "810-985-2620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOUMAA",
        "first_name": "LABIB",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-20",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4351054865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

Verify at the official NPI Registry.