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

Active since October 21, 2008PECOS Enrolled
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: November 01, 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.

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
Phone(313) 745-5629
Fax(313) 966-0105
Sole ProprietorNo
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
Open in Google Maps ↗

Other Identifiers 3

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mina Hafzalah M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Mina Hafzalah reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

University Pediatricians
Same address
Nurse Practitioner
3901 BEAUBIEN
Detroit, MI 48201
  • Reassigned Medicare billing, Michigan enrollment
  • 360 clinicians in this Medicare group
NPI 1033143904 (313) 745-5214

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

KAROLINA MAKSIMOWSKI
Pediatrics (Pediatric Emergency Medicine)
3901 BEAUBIEN ST
DETROIT, MI 48201
Wayne County (313) 745-5260
BROOKE ALISON BENOWITZ
Student in an Organized Health Care Education/Training Program
3901 BEAUBIEN ST
DETROIT, MI 48201
Wayne County (313) 745-4883
NUTRENA TATE CNP
Nurse Practitioner (Pediatrics)
3901 BEAUBIEN ST
DETROIT, MI 48201
Wayne County (313) 745-5437
DR. RUPA THACKER M.D
Pediatrics
3901 BEAUBIEN ST
DETROIT, MI 48201
Wayne County (313) 745-5533
SYBRENA EVANS
Physician Assistant (Surgical)
3901 BEAUBIEN ST
DETROIT, MI 48201
Wayne County (313) 833-4490
JOSHUA KIM DO
Pediatrics
3901 BEAUBIEN ST
DETROIT, MI 48201
Wayne County (313) 745-5870
HANNAH L MORELLO MSN, RN
Nurse Practitioner (Pediatrics)
3901 BEAUBIEN ST
DETROIT, MI 48201
Wayne County (543) 731-3745
ERIC MARC ESHMAN PHARM.D.
Pharmacist
3901 BEAUBIEN ST
DETROIT, MI 48201
Wayne County (313) 966-0414

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mina Hafzalah's NPI number?

The NPI number for Mina Hafzalah is 1083866107. It was assigned to this individual provider in the NPPES registry on October 21, 2008.

Where is Mina Hafzalah located?

Mina Hafzalah practices at 3901 Beaubien St, Detroit, MI 48201. The listed phone number is (313) 745-5629.

What is Mina Hafzalah's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Critical Care Medicine, with taxonomy code 2080P0203X.

Is Mina Hafzalah enrolled in Medicare?

Yes. Mina Hafzalah is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Mina Hafzalah's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mina Hafzalah reassigns Medicare benefits to University Pediatricians (Detroit, MI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mina Hafzalah's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Mina Hafzalah accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and Priority Health list Mina Hafzalah as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mina Hafzalah was last updated on August 14, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.