MINA HAFZALAH M.D.
NPI 1083866107
Pediatrics - Pediatric Critical Care Medicine in Detroit, MI

Active since October 21, 2008PECOS EnrolledAccepts Medicare Assignment
3901 BEAUBIEN ST, DETROIT, MI 48201(313) 745-5629(313) 966-0105 Get Directions Write a Review

NPPES record last updated: August 14, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Mina Hafzalah M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MINA HAFZALAH M.D. (NPI 1083866107) is an individual pediatric critical care medicine provider in Detroit, Michigan, licensed in Michigan (4301502539) and active in the NPI registry since October 2008. She is enrolled in Medicare PECOS and is a graduate of Other (2000).

NPPES Registry Identity

NPI1083866107
Entity TypeIndividualFemale
Primary Taxonomy2080P0203X
Provider Legal NameMINA HAFZALAHCredential: M.D.
Location Address3901 BEAUBIEN STDetroit, MI 48201-2119
Mailing Address4201 St. Antoine, Uhc 5d - Mailbox 226Detroit, MI 48201-2153 · (313) 966-5051 · Fax (313) 966-0665
Fax(313) 966-0105
Sole ProprietorNo
Medical School CMSOtherGraduated 2000
Enumeration DateOctober 21, 2008
Last NPPES UpdateAugust 14, 2020
NPPES CertifiedAugust 14, 2020
NPI 1083866107 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPediatrics · Pediatric Critical Care MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080P0203X
Licenses Licensed in MI · 4301502539 Licensed in IL · 036.117289
Definition

A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists.

3901 BEAUBIEN ST, Detroit, MI 48201

Other Identifiers 3

Other7548SD · State License
Other036.117289IL · State License
Other4301502539MI · State License

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Mina Hafzalah M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3971815192
PECOS Enrollment IDI20200826002616
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Anesthetist, Certified Registered
3901 BEAUBIEN ST
DETROIT, MI 48201
Nurse Anesthetist, Certified Registered
3901 BEAUBIEN ST
DETROIT, MI 48201
Nurse Anesthetist, Certified Registered
3901 BEAUBIEN ST
DETROIT, MI 48201
Nurse Anesthetist, Certified Registered
3901 BEAUBIEN ST
DETROIT, MI 48201
Nurse Practitioner (Pediatrics)
3901 BEAUBIEN ST
DETROIT, MI 48201
Nurse Practitioner (Pediatrics)
3901 BEAUBIEN ST, DIVISION OF UROLOGY
DETROIT, MI 48201
Thoracic Surgery (Cardiothoracic Vascular Surgery)
3901 BEAUBIEN ST
DETROIT, MI 48201
General Acute Care Hospital (Children)
3901 BEAUBIEN ST
DETROIT, MI 48201

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1083866107, enumerated as an "individual" on October 21, 2008.

The provider is located at 3901 BEAUBIEN ST DETROIT, MI 48201 and the phone number is (313) 745-5629.

Pediatrics with taxonomy code 2080P0203X and a focus in Pediatric Critical Care Medicine.

The provider might be accepting Accepts: Ambetter from Buckeye Health Plan, Ambetter from. Please consult your insurance carrier or call the provider to verify.