Hicham Churbaji, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

HC065531 Issued in MI

Practice address

2137 W M 61
Gladwin, MI 48624-8463

Phone

(989) 426-9399

Fax

(989) 246-2257

NPI assigned

May 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Internal MedicineAlso: Emergency Medicine

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Coverage LLCGroup PAC ID 3072412592, 761 clinicians

Afc Physicians of Georgia PCGroup PAC ID 0345493375, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Piedmont Walton Hospital Hospital, Monroe, GA, CCN 110046
• Piedmont Mountainside Hospital Inc Hospital, Jasper, GA, CCN 110225

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/17512/brand/1/csg/1/fhir/r4

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.

• Afc Physicians of Georgia, PC

  • Urgent Care Clinic/Center
  • Chamblee, GA
  • NPI 1982950671

  GA

  Medicare reassignment Care Compare group NPD
• Emergency Coverage, LLC

  • Family Medicine Physician
  • Newport, TN
  • NPI 1427005008

  GA, Internal Medicine

  Medicare reassignment Care Compare group NPD
• Acs Primary Care Physicians - Southeast PC

  • Emergency Medicine Physician
  • Myrtle Beach, SC
  • NPI 1861430555

  GA

  Medicare reassignment NPD
• Hartwell Emergency Physicians LLC

  • Emergency Medicine Physician
  • Hartwell, GA
  • NPI 1962540849

  GA

  Medicare reassignment NPD
• Peach State Emergency Physicians LLC

  • Emergency Medicine Physician
  • Augusta, GA
  • NPI 1053170605

  GA

  Medicare reassignment NPD
• Peachtree Immediate Care FP, LLC

  • Family Medicine Physician
  • Hiram, GA
  • NPI 1437194156

  GA

  Medicare reassignment NPD
• United Emergency Services, Inc.

  • Emergency Medicine Physician
  • Booneville, MS
  • NPI 1326007915

  GA

  Medicare reassignment NPD
• Hospital Physician Services - Southeast Professional Corporation

  • Hospitalist Physician
  • Monroe, GA
  • NPI 1760410385

  GA

  Medicare reassignment
• Gladwin Family Practice

  • Licensed Practical Nurse
  • Gladwin, MI
  • NPI 1356524789
  NPD (past) Authorized official
• Afc Physicians of Georgia, PC

  • General Practice Physician
  • Columbus, GA
  • NPI 1982025318
  NPD
• Hartwell Emergency Physicians LLC

  • Emergency Medicine Physician
  • Lavonia, GA
  • NPI 1467710152
  NPD
• Asthma, Allergy and Sinus Center, PC

  • Allergy Physician
  • Sandusky, MI
  • NPI 1093720740
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Piedmont Mountainside Hospital, Inc.

  • General Acute Care Hospital
  • Jasper, GA
  • NPI 1780643411

  Hospital

  Care Compare affiliation
• Piedmont Walton Hospital Inc

  • General Acute Care Hospital
  • Monroe, GA
  • NPI 1720589328

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216080000000",
    "number": "1629023924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3061 CHRISTY WAY",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486032267",
            "telephone_number": "989-791-2455",
            "fax_number": "989-791-1392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2137 W M 61",
            "city": "GLADWIN",
            "state": "MI",
            "postal_code": "486248463",
            "telephone_number": "989-426-9399",
            "fax_number": "989-246-2257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURBAJI",
        "first_name": "HICHAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2008-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "HC065531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629023924",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY CHOICE",
            "identifier": "383567566100",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MICHIGAN",
            "identifier": "110B610050",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Breanna Raven Castillo
• Cedar Avenue Family Practice, P.C.
• Savannah Lynn Celestino, RN
• Danielle Champ, RN
• Chloee K. Malcolm PLLC
• Kourtney Cingano
• Salvatore Steven Ciraulo, BCBA
• Gerald Junior Clements Jr.
• Clinical Hospital Pharmacy Management, P.C.
• Carlee Collison

• All providers in Gladwin, MI
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2008; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.