Individual provider Active NPI

Mina Rafed Ibrahim

  • Obstetrics & Gynecology Physician
  • Rochester Hills, MI
National Provider Identifier
1689253460
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
5101028845 Issued in MI
Practice address
2657 Long Meadow LN
Rochester Hills, MI 48307-5927
Phone
(248) 513-0906
NPI assigned
Apr 7, 2021
Last updated
Sep 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 5101028845 MI Primary

Addresses

Primary practice location

2657 Long Meadow LN
Rochester Hills, MI 48307-5927

Mailing address

2657 Long Meadow LN
Rochester Hills, MI 48307-5927
Phone (248) 513-0906

Other practice location 1

44201 Dequindre Rd
Troy, MI 48085-1117
Phone (248) 964-5100

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mibrahim3452083@epic00.corewelldirect.org

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
I20260113001935 MI Practitioner - Obstetrics/Gynecology 9133514664 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Michigan State University College of Osteopathic Medicine, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

26901 Beaumont Blvd
Southfield, MI 48033-3849

3950 S Rochester Rd
Suite 1450
Rochester Hills, MI 48307-5162

5860 N Canton Rd
Suite 360
Canton, MI 48187-2759

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Serenity OBGYN PLLC Obstetrics & Gynecology CurrentSince Nov 17, 2025 Accepting new patients

Locations

3950 S Rochester Rd
Ste 1450
Rochester Hills, MI 48307
Phone (248) 310-9486

Interoperability endpoints

  • Direct secure messaging: mina.ibrahim.1@30230.direct.athenahealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1617753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1689253460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2657 LONG MEADOW LN",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483075927",
            "telephone_number": "248-513-0906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2657 LONG MEADOW LN",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483075927",
            "telephone_number": "248-513-0906"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44201 Dequindre Rd",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480851117",
            "country_code": "US",
            "telephone_number": "248-964-5100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "MINA",
        "middle_name": "RAFED",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-07",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "5101028845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mibrahim3452083@epic00.corewelldirect.org",
            "affiliation": "N",
            "address_1": "44201 Dequindre Rd",
            "city": "Troy",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480851117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester Hills, MI

Sources for this page

Verify at the official NPI Registry.