MICHIANA HEMATOLOGY ONCOLOGY OF MICHIGAN, P.C. (NPI# 1295874014) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295874014 |
| Entity Type | Organization |
| Organization Name | MICHIANA HEMATOLOGY ONCOLOGY OF MICHIGAN, P.C. |
| Practice Address |
4 Longmeadow Drive Suite 1 Niles MI 49120 |
| Mailing Address |
100 Navarre Pl Suite 6695 South Bend IN 46601-1156 |
| Practice Telephone | 2696834153 |
| Practice Fax Number | 2696834154 |
| Mailing Telephone | 5742345123 |
| Mailing Fax Number | 5742371341 |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | RAFAT H ANSARI (PRESIDENT) |
| Authorized Official Telephone | 5742345123 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians | ||
| X | 207VX0201X |
Obstetrics & Gynecology Specialization: Gynecologic Oncology |
Allopathic & Osteopathic Physicians | ||
| X | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BLUE CROSS | OA11038 | 01 |
| MI | NSC | 4815650001 | 01 |
| MI | RRMC PROVIDER | DA4426 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235134461 | Michiana Hematology Oncology of Michigan, P.C. | Obstetrics & Gynecology | 4 Longmeadow Drive, Suite One, Niles, MI 49120 | 2005-06-15 |
| Street Address |
4 LONGMEADOW DRIVE SUITE 1 |
| City | NILES |
| State | MI |
| Zip Code | 49120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235134461 | Michiana Hematology Oncology of Michigan, P.C. | Obstetrics & Gynecology | 4 Longmeadow Drive, Suite One, Niles, MI 49120 | 2005-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093285652 | The Caerus Group LLC | Clinic/Center | 732 S. 11th St #197, Niles, MI 49120 | 2018-11-27 |
| 1306316971 | Vicki L Yarbro | Physical Therapist | 6 Longmeadow Village Dr. Suite 3, Niles, MI 49120 | 2018-11-27 |
| 1063831469 | Aaron Joseph Lanning | Nurse Practitioner | 42 N Saint Joseph Ave Ste 300, Niles, MI 49120 | 2014-04-14 |
| 1740601186 | Terrianne Klaeren | Occupational Therapist | 1009 Almaugus Drive, Niles, MI 49120 | 2014-01-03 |
| 1124469366 | All Needs Senior Services, Inc. | Home Health | 1723 Pucker Street Dr, Suite A, Niles, MI 49120 | 2013-07-16 |
| 1902105034 | Nile Family Pharmacy LLC | Pharmacy | 70 E. State St., Niles, MI 49120 | 2011-03-15 |
| 1629240734 | Karen L Palmer | Counselor | 115 S St Joseph Ave, Niles, MI 49120 | 2008-03-28 |
| 1124218391 | Melissa A Longley | Social Worker | 333 N. Second Street, Suite 303, Niles, MI 49120 | 2007-07-25 |
| 1841410727 | Periza Zaninovic | Dentist | 123 Marmont Street, Niles, MI 49120 | 2007-04-26 |
| 1477629087 | Stephen Williams Tankersley | Dentist | 226 S Lincoln Ave, Niles, MI 49120 | 2006-11-27 |
| Find all providers in zip 49120 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255328878 | Leonard M Klein | Internal Medicine | 8915 W Golf Rd, Niles, IL 60714-5905 | 2005-09-29 |
| 1578979415 | Lakeland Medical Practices | Internal Medicine | 42 N Saint Joseph Ave, Suite 302, Niles, MI 49120-2203 | 2014-07-10 |
| 1891038204 | Sonia Christian | Internal Medicine | 8915 W Golf Rd, Niles, IL 60714 | 2013-04-03 |
| 1619219722 | Kristen Wendell | Internal Medicine | 8915 W Golf Rd, Niles, IL 60714 | 2013-03-27 |
| 1912027434 | Oncology Specialists,sc | Internal Medicine | 7900 N Milwaukee Ave, Suite 16, Niles, IL 60714-3159 | 2007-03-29 |
| 1164483913 | Illinois Cancer Specialists | Internal Medicine | 8915 W Golf Rd, Niles, IL 60714-5905 | 2006-03-31 |
| 1003805375 | Susan G Brown | Internal Medicine | 8915 W Golf Rd, Niles, IL 60714-5905 | 2005-10-19 |
| 1407843857 | Leonard A Kosova | Internal Medicine | 8915 W Golf Rd, 3rd Floor, Niles, IL 60714-5905 | 2005-09-30 |
| 1174510523 | John W Eklund | Internal Medicine | 8915 W Golf Rd, Niles, IL 60714-5905 | 2005-09-30 |
| 1972590347 | David Hakimian | Internal Medicine | 8915 W Golf Rd, Niles, IL 60714-5905 | 2005-09-30 |
| Find all providers in NILES | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.