Elberta Dziobak, CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

4704248684 Issued in MI

Practice address

3990 John R St
Detroit, MI 48201-2018

Phone

(313) 993-3456

Fax

(313) 993-4100

NPI assigned

Mar 22, 2019

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: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Certified Nurse Midwife (CNM)

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University Physician GroupGroup PAC ID 8628087681, 399 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: elberta.dziobak.1@19711.direct.athenahealth.com

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.

• University Physician Group

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1447299797
  Medicare reassignment Care Compare group NPD
• University Physician Group

  • Social Worker
  • Livonia, MI
  • NPI 1154360402
  NPD (past)

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

{
    "created_epoch": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574294400000",
    "number": "1851851224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3990 JOHN R ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012018",
            "telephone_number": "313-993-3456",
            "fax_number": "313-993-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3990 JOHN R ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012018",
            "telephone_number": "313-993-3456",
            "fax_number": "313-993-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DZIOBAK",
        "first_name": "ELBERTA",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-22",
        "last_updated": "2019-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MI",
            "license": "4704248684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dynasty Physical Therpay and Rehabilitation, PC
• Dynasty Senior Center
• Casandra Dysard
• Malgorzata Dziadkowiec
• Patricia Dzieciolowski, MSW,CSW
• John T Dziuba, MD
• E & G Medical Associates PC
• E Davidson RX LLC
• Lenricco E Williams
• Raven-Dunaj Eaddy, LLMSW

• Advanced Practice Midwife in Detroit, MI
• Providers in Detroit, MI by specialty
• Advanced Practice Midwife in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.