Individual provider Active NPI

Hana Joy Kallabat, MD

  • Emergency Medicine Physician
  • Southfield, MI
National Provider Identifier
1811637507
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
4301513007 Issued in MI
Practice address
16001 W 9 Mile Rd Ste 401
Southfield, MI 48075-4818
Phone
(248) 849-2407
NPI assigned
Mar 30, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4301513007 MI Primary

Addresses

Primary practice location

16001 W 9 Mile Rd Ste 401
Southfield, MI 48075-4818

Mailing address

37000 Grand River Ave Ste 310
Farmington Hills, MI 48335-2868
Phone (248) 536-2127

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250325002783 MI Practitioner - Emergency Medicine 5698298172 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Independent Observation Physicians PLLCGroup PAC ID 3577603604, 138 clinicians
Independent Emergency Physicians PCGroup PAC ID 6709798325, 173 clinicians

Practice addresses (Care Compare)

16001 W 9 Mile Rd
Southfield, MI 48075-4818
Phone (248) 849-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301513007MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Emergency Physicians, P.C. CurrentSince Apr 8, 2025 Accepting new patients
Independent Observation Physicians PLLC CurrentSince Mar 1, 2025 Accepting new patients

Locations

37000 Grand River Ave
Ste 310
Farmington Hills, MI 48335
Phone (913) 223-0811

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

47601 Grand River Ave
Novi, MI 48374
Phone (248) 465-4100

16001 W 9 Mile Rd
Southfield, MI 48075
Phone (248) 424-3000

16001 W 9 Mile Rd
Ste 401
Southfield, MI 48075
Phone (248) 849-2407

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.

Hospital & facility affiliations 2

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": "1648598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1811637507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37000 GRAND RIVER AVE STE 310",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483352868",
            "telephone_number": "248-536-2127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16001 W 9 MILE RD STE 401",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754818",
            "telephone_number": "248-849-2407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALLABAT",
        "first_name": "HANA",
        "middle_name": "JOY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-30",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301513007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.