NPIMap

Sophia I Mehboob, M.D.

Individual provider Active NPI Pulmonary Disease Physician · Detroit, MI

NPI 1861693772 · NPPES record last updated Aug 31, 2021

Key facts

NPI
1861693772
Entity type
Individual (NPI type 1)
Primary specialty
Pulmonary Disease Physician 207RP1001X
License
4301091877 (MI)
Practice address
2799 W Grand Blvd
Detroit, MI 48202-2608
Phone
(313) 916-4906
NPI assigned
May 29, 2007
Sex
Female
Sole proprietor
Yes

Organizations & group practices 15

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 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Medicare Care Compare profile

Specialty
Pulmonary Disease
Also: Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Wyandotte Hospital (194 clinicians)
Henry Ford Health System (2,550 clinicians)

Practice addresses (Care Compare)

2333 Biddle Ave
Wyandotte, MI 48192-4668
Phone (734) 246-6000

24555 Haig St
Taylor, MI 48180-3322
Phone (313) 375-2000

24565 Haig St
Taylor, MI 48180-3322
Phone (313) 291-7800

2799 W Grand Blvd
Detroit, MI 48202-2608

Hospital & facility affiliations

  • Wyandotte Hospital and Medical Center Hospital · Wyandotte, MI · CCN 230146
  • Henry Ford Health Hospital Hospital · Detroit, MI · CCN 230053

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20140227000977 MI Practitioner - Pulmonary Disease
Practitioner - Internal Medicine
Practitioner - Critical Care (Intensivists)		 1951531573 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
5501010517MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Wyandotte Hospital Current
since Aug 26, 2021		 Accepting new patients
Henry Ford Wyandotte Hospital Pulmonary Disease Current
since Aug 26, 2021		 Accepting new patients
Henry Ford Pathology Current Accepting new patients
Henry Ford Health System Internal Medicine Current
since Jul 1, 2014		 Accepting new patients
Henry Ford Wyandotte Hospital Current Accepting new patients
Henry Ford Health System Current Accepting new patients
Henry Ford Health System Current
since Jul 1, 2014		 Accepting new patients
Henry Ford Wyandotte Hospital Past Accepting new patients

Locations

23050 West Rd
Ste 120
Brownstown Twp, MI 48183
Phone (734) 671-1510

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

6777 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 325-1000

2070 Biddle Ave
Ste 2
Wyandotte, MI 48192
Phone (734) 284-7482

2333 Biddle Ave
Wyandotte, MI 48192
Phone (734) 246-6000

Interoperability endpoints

  • Direct secure messaging: smehboob14110@direct.hfhs.org

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301091877 MI
Physical Therapist 225100000X 5501010517 MI
Pulmonary Disease Physician 207RP1001X 4301091877 MI Yes

Addresses

Primary practice location

2799 W Grand Blvd
Detroit, MI 48202-2608

Mailing address

15511 Reeck Rd
Southgate, MI 48195-2651
Phone (734) 282-1117

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 31, 2021.

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1861693772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15511 REECK RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952651",
            "telephone_number": "734-282-1117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "313-916-4906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHBOOB",
        "first_name": "SOPHIA",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-29",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301091877",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501010517",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MI",
            "license": "4301091877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

All providers in Detroit, MI · Pulmonary Disease Physician in Michigan

Sources for this page

Verify at the official NPI Registry.