NPIMap

Organization Active NPI

Iha Ooma Primary LLC

  • Family Medicine Physician
  • Commerce TWP, MI
National Provider Identifier
1780470179
Registry record updated Mar 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
IHA OOMA PRIMARY LLC
Practice address
4123 Martin Rd Ste 102
Commerce TWP, MI 48390-4151
Phone
(248) 366-3700
NPI assigned
Apr 15, 2025
Last updated
Mar 24, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2026

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

Authorized official

Name
Cynthia A Elliott
Title
President
Phone
(734) 747-6766

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Internal Medicine Physician 207R00000X NU

Addresses

Primary practice location

4123 Martin Rd Ste 102
Commerce TWP, MI 48390-4151

Mailing address

24 Frank Lloyd Wright Dr Ste J2000
Ann Arbor, MI 48105-9484
Phone (734) 747-6766

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210601002563 MI Part B Supplier - Clinic/Group Practice 7012316664 Receives reassigned benefits from 50 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lake Orion, MI; Waterford, MI; Rochester Hills, MI; Pontiac, MI; Commerce Township, MI; Bloomfield Township, MI; Clarkston, MI

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Cobius Healthcare Solutions10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

43097 Woodward Ave
Ste 204
Bloomfield Township, MI 48302
Phone (248) 334-3136

1854 W Auburn Rd
Rochester Hills, MI 48309
Phone (248) 696-3170

Practitioners & affiliated clinicians

Practitioners 56

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 56

NPI Registry JSON

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

{
    "created_epoch": "1744675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774310400000",
    "number": "1780470179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DR STE J2000",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "telephone_number": "734-747-6766",
            "fax_number": "734-222-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4123 MARTIN RD STE 102",
            "city": "COMMERCE TWP",
            "state": "MI",
            "postal_code": "483904151",
            "telephone_number": "248-366-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IHA OOMA PRIMARY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-15",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A",
        "authorized_official_last_name": "ELLIOTT",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "734-747-6766"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Commerce TWP, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.