Individual provider Active NPI

Enaia B Nabha, M.D.

  • Internal Medicine Physician
  • Roseville, MI
National Provider Identifier
1881907418
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
AO3066265843 Issued in MI
Practice address
26390 Gratiot Ave
Roseville, MI 48066-5106
Phone
(586) 221-7020
Fax
(586) 580-7485
NPI assigned
Jul 25, 2010
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X AO3066265843 MI Primary

Addresses

Primary practice location

26390 Gratiot Ave
Roseville, MI 48066-5106

Mailing address

30 W Monroe St Ste 1200
Chicago, IL 60603-2420
Phone (312) 733-9730

Other identifiers 1

IdentifierTypeStateIssuer
1881907418MedicaidMI

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
I20140206000825 MI Practitioner - Internal Medicine 8426287863 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Wayne State University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osh Mi Physicians Group, PCGroup PAC ID 7810282191, 154 clinicians

Practice addresses (Care Compare)

1663 S Westnedge Ave
Kalamazoo, MI 49008-1928
Phone (269) 694-3001

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AO3066265843MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osh-Mi Physicians Group PC Internal Medicine CurrentSince Nov 30, 2020 Accepting new patients
Osh Mi Physicians Group, PC CurrentSince Nov 30, 2020 Accepting new patients
Osh-Mi Physicians Group PC Internal Medicine Past Accepting new patients
Concerto Healthcare Services, Inc. Past Accepting new patients

Locations

30 W Monroe St
Ste 1200
Chicago, IL 60603
Phone (773) 609-1758

102 W Pierson Rd
Flint, MI 48505
Phone (810) 222-3033

1663 S Westnedge Ave
Kalamazoo, MI 49008
Phone (269) 694-3001

26390 Gratiot Ave
Roseville, MI 48066
Phone (586) 221-7020

Interoperability endpoints

  • Direct secure messaging: enabha379965@direct.hfhs.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1280016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1881907418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 W MONROE ST STE 1200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606032420",
            "telephone_number": "312-733-9730",
            "fax_number": "773-866-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26390 GRATIOT AVE",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480665106",
            "telephone_number": "586-221-7020",
            "fax_number": "586-580-7485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NABHA",
        "first_name": "ENAIA",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-25",
        "last_updated": "2022-07-21",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "AO3066265843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1881907418",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MI

Sources for this page

Verify at the official NPI Registry.