Lydia Yenoby Nganongo, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704372556 Issued in MI

Practice address

45937 Windridge LN
Canton, MI 48188-6224

Phone

(504) 919-4486

NPI assigned

Apr 24, 2025

Last updated

Jul 31, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

University of South Alabama College of Medicine, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Osh Mi Physicians Group, PCGroup PAC ID 7810282191, 154 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Health Oakland Hospital Hospital, Pontiac, MI, CCN 230029

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Osh-Mi Physicians Group PC

  • Primary Care Clinic/Center
  • Detroit, MI
  • NPI 1700236478
  Medicare reassignment Care Compare group NPD
• Vitality Visiting Physicians, PLLC

  • General Practice Physician
  • Garden City, MI
  • NPI 1073230876
  Medicare reassignment NPD
• Osh Mi Physicians Group, PC

  • Primary Care Clinic/Center
  • Memphis, TN
  • NPI 1720635790
  NPD
• Infinity Visiting Physician Services PLC

  • Internal Medicine Physician
  • Southfield, MI
  • NPI 1437572930
  NPD (past)

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

• St Joseph Mercy Hospital-SMHC

  dba St Joseph Mercy Oakland

  • General Acute Care Hospital
  • Pontiac, MI
  • NPI 1053356352
  Care Compare affiliation

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

{
    "created_epoch": "1745452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753920000000",
    "number": "1710774393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746723",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746723",
            "telephone_number": "312-733-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45937 WINDRIDGE LN",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481886224",
            "telephone_number": "504-919-4486"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "462 N Telegraph Rd",
            "address_purpose": "LOCATION",
            "city": "Pontiac",
            "state": "MI",
            "postal_code": "483411037",
            "country_code": "US",
            "telephone_number": "248-234-7540",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGANONGO",
        "first_name": "LYDIA",
        "middle_name": "YENOBY",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-24",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704372556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Reeda Niazi, PHARMD
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• Stana Nickolich, MD
• Nicole D Teifer DDS PLLC (North Canton Orthodontics PLLC)

• Family Nurse Practitioner in Canton, MI
• Providers in Canton, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2025; 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.