Minna Shaba, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704387649 Issued in MI

Practice address

28903 Woodward Ave
Berkley, MI 48072-0924

Phone

(248) 581-0333

NPI assigned

Nov 22, 2024

Last updated

Nov 22, 2024By 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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

State licenses

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.

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  • NPI 1275022519
  Medicare reassignment NPD
• Alan Bolton, MD, PC

  • Obstetrics & Gynecology Physician
  • Berkley, MI
  • NPI 1467632901
  NPD

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

{
    "created_epoch": "1732233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1770308884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28903 WOODWARD AVE",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480720924",
            "telephone_number": "248-581-0333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28903 WOODWARD AVE",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480720924",
            "telephone_number": "248-581-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHABA",
        "first_name": "MINNA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-22",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704387649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janell E Schmid, N.P.
• Stacey Schwartz, DPT
• Philip Sciturro, M.D.
• Paola M Seidel, M.D.
• Autumn Serowoky
• Ellen Shafer, RN, FNP
• Alka Yatrik Shah, MD
• Dinesh M Shah, MD
• Rita Shah, MD
• Yaser Shaheen, DMD

• Family Nurse Practitioner in Berkley, MI
• Providers in Berkley, 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 Nov 22, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.