Active NPI
Galina Petlakh
- Administrator Registered Nurse
- Birmingham, MI
National Provider Identifier
1992511588
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Administrator Registered Nurse
- License
- 4704211679
- Practice address
- 608 Purdy St
Birmingham, MI 48009-1795 - Phone
- (248) 320-7295
- NPI assigned
- Dec 9, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | |||
| Administrator Registered Nurse | 163WA2000X | 4704211679 | MI | Primary |
Addresses
Primary practice location
608 Purdy St
Birmingham, MI 48009-1795
Mailing address
608 Purdy St
Birmingham, MI 48009-1795
Phone (248) 320-7295
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Undefined Non-Physician Type (Specify)
- Education
- Michigan College of Medicine and Surgery, 2020
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
608 Purdy St
Birmingham, MI 48009-1795
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704211679 | MI | MD | Administrator Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| GLS Solution LLC | Community Health Worker | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Community Health Worker
- Birmingham, MI
- NPI 1922813054
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1733702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736553600000",
"number": "1992511588",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "608 PURDY ST",
"city": "BIRMINGHAM",
"state": "MI",
"postal_code": "480091795",
"telephone_number": "248-320-7295"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "608 PURDY ST",
"city": "BIRMINGHAM",
"state": "MI",
"postal_code": "480091795",
"telephone_number": "248-320-7295"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETLAKH",
"first_name": "GALINA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-12-09",
"last_updated": "2025-01-11",
"certification_date": "2025-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "163WA2000X",
"taxonomy_group": "",
"desc": "Registered Nurse, Administrator",
"state": "MI",
"license": "4704211679",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Birmingham, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2025; 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.