Hiba Abu Suhaiban, M.D
Individual provider Active NPI Psychiatry Physician · Jackson, MI
NPI 1972090801 · NPPES record last updated Mar 31, 2023
Key facts
- NPI
- 1972090801
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 4301508085 (MI)
- Practice address
- 205 N East Ave
Jackson, MI 49201-1753 - Phone
- (517) 205-4800
- Fax
- (517) 205-7828
- NPI assigned
- Apr 17, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 13
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Psychiatry
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- W. a. Foote Memorial Hospital, Inc.
Practice addresses (Care Compare)
205 N E Ave
Henry Ford Allegiance Health
Jackson, MI 49201-1753
Phone (517) 205-4800
Hospital & facility affiliations
- Henry Ford Allegiance Health
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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230404000752 | MI | Practitioner - Psychiatry | 1759637218 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301508085 | MI | MD | Psychiatry Physician |
| 35.141665 | OH | MD | Child & Adolescent Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| W.a. Foote Memorial Hospital, Inc | Current |
Accepting new patients | |
| Wa Foote Memorial Hospital, Inc | Current | Accepting new patients | |
| W.a. Foote Memorial Hospital, Inc | Psychiatry | Current |
Accepting new patients |
Locations
1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-2892
205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730
205 S East Ave
Jackson, MI 49201
Phone (517) 205-2103
Interoperability endpoints
- habusuhaiban882996@direct.hfhs.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | 35.141665 | OH | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Psychiatry Physician | 2084P0800X | 4301508085 | MI | Yes |
Addresses
Primary practice location
205 N East Ave
Jackson, MI 49201-1753
Mailing address
1 Ford PL Ste 3a
Detroit, MI 48202-3450
Phone (313) 874-4806
Other practice location 1
10524 Euclid Avenue, 8th floor
suite 8107 W.O Walker Center
Cleveland, OH 44106
Phone (216) 844-4741
Other providers in Jackson, MI
- Ashraf Shaaban Abdel Aziz Abou El Ela
- Iman S Abou-Chakra
- Manell Aboutaleb
- Emily Abraham
- Denise Claire Abrams
- Sarah Lynn Ackerman
- Active Care Chiropractic Inc
- Acton Family Counseling
- Marilyn M Acton
- Courtney Jean Adair
All providers in Jackson, MI · Psychiatry Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 31, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.