Individual provider Active NPI

Chibuzo Casey Ohanaja, MD

  • Family Medicine Physician
  • Detroit, MI
National Provider Identifier
1720609001
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301514624 Issued in MI
Practice address
4201 Saint Antoine St # 9C
Detroit, MI 48201-2153
Phone
(574) 520-3551
NPI assigned
Apr 28, 2020
Last updated
Sep 15, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301514624 MI Primary

Addresses

Primary practice location

4201 Saint Antoine St # 9C
Detroit, MI 48201-2153

Mailing address

Detroit Medical Center Gme Office
4201 Saint Antoine St # Uhc-9C
Detroit, MI 48201
Phone (574) 520-3551

Other identifiers 1

IdentifierTypeStateIssuer
100262074MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240117001544 WI Practitioner - Family Practice 7315368909
I20250924003495 MI Practitioner - Family Practice 7315368909 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

502 Hunter Bend Dr
Mansfield, TX 76063-7511

6 E Eager St
Baltimore, MD 21202-2506

9722 Groffs Mill Dr
Owings Mills, MD 21117-6341

PO Box
Cincinnati, OH 45263

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
M Medical Mi PLLC CurrentSince Jul 19, 2025 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jan 3, 2024 Accepting new patients
Aurora Medical Group, Inc. Family Medicine CurrentSince Jan 3, 2024 Accepting new patients
M Medical Mi PLLC CurrentSince Jul 19, 2025 Accepting new patients
Pai Participant 18 PC CurrentSince Oct 13, 2025 Accepting new patients
Madonna Acquisition Company Inc. Past Accepting new patients
Outer Drive Partners LLC Past Accepting new patients

Locations

5201 Conner St
Detroit, MI 48213
Phone (313) 571-5555

3003 W Grand River Ave
Howell, MI 48843
Phone (517) 323-9133

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

2414 Kohler Memorial Dr
Sheboygan, WI 53081
Phone (920) 457-4461

Organizations & group practices 8

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.

Hospital & facility affiliations 1

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": "1588032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789430400000",
    "number": "1720609001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DETROIT MEDICAL CENTER GME OFFICE",
            "address_2": "4201 SAINT ANTOINE ST # UHC-9C",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48201",
            "telephone_number": "574-520-3551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 SAINT ANTOINE ST # 9C",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "574-520-3551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OHANAJA",
        "first_name": "CHIBUZO",
        "middle_name": "CASEY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-28",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301514624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100262074",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.