Individual provider Active NPI

Irina Papusha, AGPC-C

  • Gerontology Nurse Practitioner
  • Farmington Hills, MI
National Provider Identifier
1770234056
Registry record updated Feb 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AG12210043 Issued in MI
Practice address
31500 W 13 Mile Rd Ste 100
Farmington Hills, MI 48334-2172
Phone
(248) 509-4070
Fax
(248) 509-4080
NPI assigned
Jan 18, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X AG12210043 MI Primary

Addresses

Primary practice location

31500 W 13 Mile Rd Ste 100
Farmington Hills, MI 48334-2172

Mailing address

31500 W 13 Mile Rd Ste 100
Farmington Hills, MI 48334-2172
Phone (248) 509-4070

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220224001869 MI Practitioner - Nurse Practitioner 0345634945 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michigan Rehabilitation PhysiciansGroup PAC ID 4385824382, 11 clinicians

Practice addresses (Care Compare)

17187 Schaefer Hwy
Detroit, MI 48235-4132
Phone (313) 367-2767

Merit-based Incentive Payment System (MIPS)

Final score
96.25 of 100Reported as group
Quality
88.34
Improvement activities
40
Cost
69.71

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AG12210043MIMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
VPS of Mi PLLC CurrentSince Feb 6, 2022 Accepting new patients
Michigan Rehabilitation Physicians CurrentSince Oct 23, 2023 Accepting new patients

Locations

17187 Schaefer Hwy
Detroit, MI 48235
Phone (313) 342-9255

14825 W McNichols Rd
Detroit, MI 48235
Phone (313) 838-7900

31500 W 13 Mile Rd
Ste 100
Farmington Hills, MI 48334
Phone (248) 509-4070

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1642464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1770234056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31500 W 13 MILE RD STE 100",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483342172",
            "telephone_number": "248-509-4070",
            "fax_number": "248-509-4080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31500 W 13 MILE RD STE 100",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483342172",
            "telephone_number": "248-509-4070",
            "fax_number": "248-509-4080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAPUSHA",
        "first_name": "IRINA",
        "credential": "AGPC-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-18",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "AG12210043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

Verify at the official NPI Registry.