Andrea Mary Mobilio, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

4301080412 Issued in MI

Practice address

4125 Washtenaw Ave
Ann Arbor
Ann Arbor, MI 48108-1003

Phone

(734) 973-4343

Fax

(734) 973-4484

NPI assigned

Mar 31, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• County of Washtenaw

  • State or Local Public Health Clinic/Center
  • Ypsilanti, MI
  • NPI 1609896018
  NPD
• County of Washtenaw

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Ypsilanti, MI
  • NPI 1639132442
  NPD

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

{
    "created_epoch": "1175299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332115200000",
    "number": "1982724837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 TOWNER ST",
            "address_2": "PO BOX 915",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481985752",
            "telephone_number": "734-544-3000",
            "fax_number": "734-544-6732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4125 WASHTENAW AVE",
            "address_2": "ANN ARBOR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081003",
            "telephone_number": "734-973-4343",
            "fax_number": "734-973-4484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOBILIO",
        "first_name": "ANDREA",
        "middle_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-31",
        "last_updated": "2012-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301080412",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MI",
            "license": "4301080412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "750910468",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5304519",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• MKL Co
• Okeoma Onyekachi Mmeje, MD
• Nnenaya Agochukwu Mmonu, MD
• MNH Health Care PC
• Roubir R Moawad, PHARMD
• Natalie Harris Mobley, CRNP
• Alexandra Renee Mock, NP
• Immanuel Mock
• Emmeline Nierra Mocorro-Ma, NP
• Zubin Juzer Modi, MD

• Child & Adolescent Psychiatry Physician in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Child & Adolescent Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.