Individual provider Active NPI

Siham Gellani, CNM

  • Advanced Practice Midwife
  • Dearborn, MI
National Provider Identifier
1700426616
Registry record updated Jan 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
4704266870 Issued in MI
Practice address
25080 Michigan Ave
Dearborn, MI 48124-1740
Phone
(313) 730-8880
Fax
(313) 730-1167
NPI assigned
Jan 8, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 4704266870 MI Primary

Addresses

Primary practice location

25080 Michigan Ave
Dearborn, MI 48124-1740

Mailing address

25080 Michigan Ave
Dearborn, MI 48124-1740
Phone (313) 730-8880

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200210001578 MI Practitioner - Certified Nurse Midwife (CNM) 3678909785 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dearborn Obstetrical and Gynecological Associates, P.C.Group PAC ID 4880719715, 5 clinicians

Practice addresses (Care Compare)

25080 Michigan Ave
Dearborn, MI 48124-1740
Phone (313) 730-8880

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
4704266870MIMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Dearborn Obstetrical and Gynecological Associates, P.C. CurrentSince Jan 8, 2020 Accepting new patients

Locations

25080 Michigan Ave
Dearborn, MI 48124
Phone (313) 730-8880

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1578441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578441600000",
    "number": "1700426616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25080 MICHIGAN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481241740",
            "telephone_number": "313-730-8880",
            "fax_number": "313-730-1167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25080 MICHIGAN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481241740",
            "telephone_number": "313-730-8880",
            "fax_number": "313-730-1167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GELLANI",
        "first_name": "SIHAM",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-08",
        "last_updated": "2020-01-08",
        "certification_date": "2020-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MI",
            "license": "4704266870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.