Individual provider Active NPI

Mona Z Obeidy, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Dearborn, MI
National Provider Identifier
1780655076
Registry record updated Dec 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
4301054803 Issued in MI
Practice address
116 S Denwood St
Dearborn, MI 48124-1310
Phone
(734) 467-4150
Fax
(734) 467-4251
NPI assigned
Jan 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 4301054803 MI Primary

Addresses

Primary practice location

116 S Denwood St
Dearborn, MI 48124-1310

Mailing address

Dept 259301
P O Box 67000
Detroit, MI 48267-2593
Phone (734) 467-4150

Other identifiers 1

IdentifierTypeStateIssuer
1780655076MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301054803MIMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oakwood Healthcare, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mobeidy356143@direct.hfhs.org

Organizations & group practices 1

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": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448928000000",
    "number": "1780655076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 259301",
            "address_2": "P O BOX 67000",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482672593",
            "telephone_number": "734-467-4150",
            "fax_number": "734-467-4251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 S DENWOOD ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481241310",
            "telephone_number": "734-467-4150",
            "fax_number": "734-467-4251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBEIDY",
        "first_name": "MONA",
        "middle_name": "Z",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-27",
        "last_updated": "2015-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MI",
            "license": "4301054803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780655076",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.