KAUSTUBH ARVIND PRABHU (NPI# 1083176036) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083176036 |
| Entity Type | Individual |
| Full Name | KAUSTUBH ARVIND PRABHU |
| Credential | MD |
| Practice Address |
5333 Mcauley Dr Rm 2110 Ypsilanti MI 48197-1097 |
| Mailing Address |
778 Bogey Ct Ann Arbor MI 48103-8844 |
| Practice Telephone | 7347123967 |
| Mailing Telephone | 7343328860 |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2019-04-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
5333 MCAULEY DR RM 2110 |
| City | YPSILANTI |
| State | MI |
| Zip Code | 48197-1097 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174828446 | Alexandria Marie Sara | Nurse Practitioner | 5333 Mcauley Dr Rm 2110, Ypsilanti, MI 48197-1097 | 2011-01-18 |
| 1235767310 | Aakriti Shrestha | Student in an Organized Health Care Education/Training Program | 5333 Mcauley Dr Rm 2110, Ypsilanti, MI 48197-1097 | 2020-04-01 |
| 1790245892 | Amma Serwaa Owusu-akyaw | Student in an Organized Health Care Education/Training Program | 5333 Mcauley Dr Rm 2110, Ypsilanti, MI 48197-1097 | 2019-03-23 |
| 1992281844 | Melissa Roth | Social Worker | 5333 Mcauley Dr Rm 2110, Ypsilanti, MI 48197-1097 | 2018-07-13 |
| 1477916427 | Tina Chaalan | Student in an Organized Health Care Education/Training Program | 5333 Mcauley Dr Rm 2110, Ypsilanti, MI 48197-1097 | 2016-03-29 |
| 1033524962 | Katharine Micallef | Obstetrics & Gynecology | 5333 Mcauley Dr Rm 2110, Ypsilanti, MI 48197-1097 | 2014-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700423092 | Devika Dibya Choudhuri | Counselor | 135 Porter West Circle Drive, Ypsilanti, MI 48197 | 2019-12-05 |
| 1770128837 | Brian Lee Shue | Registered Nurse | 6277 Maplehurst Dr, Ypsilanti, MI 48197 | 2019-11-13 |
| 1639721566 | Darlene E Bellers | 845 W. Circle Dr, Suite 160, Ypsilanti, MI 48197 | 2019-07-11 | |
| 1073165874 | Eastern Michigan University | Dietitian, Registered | Suite 160 Rackham, Ypsilanti, MI 48197 | 2019-07-11 |
| 1447815469 | Rainbow Rehabilitation Centers, Inc. | Community Based Residential Treatment Facility, Mental Illness | 6200 Textile Rd, Ypsilanti, MI 48197 | 2019-05-06 |
| 1417416298 | Justin Brewer | Student in an Organized Health Care Education/Training Program | 5333 Mcauley Drive Suite 2115, Ypsilanti, MI 48197 | 2019-03-19 |
| 1124519780 | Great Lakes Mindfulness LLC | Community/Behavioral Health | 4007 Carpenter Rd # 280, Ypsilanti, MI 48197 | 2018-05-19 |
| 1841799715 | Bedside Angel's Home Care, LLC | Home Health | 2032 S. Congress Street, Ypsilanti, MI 48197 | 2018-02-06 |
| 1891211777 | Brandon James Kukal | Specialist/Technologist | 799 N Hewitt, Ypslinati, MI 48197 | 2017-08-22 |
| 1669908737 | Michael Bekkerman | Student in an Organized Health Care Education/Training Program | 5303 Elliot Drive, Cancer Center, Ypsilanti, MI 48197 | 2017-05-10 |
| Find all providers in zip 48197 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306453303 | Eddie D Williams | Student in an Organized Health Care Education/Training Program | 507 Pearl St, Ypsilanti, MI 48197-2076 | 2020-09-24 |
| 1548878390 | Mobina Shrestha | Student in an Organized Health Care Education/Training Program | 5333 Mcauley Drive, Academic Internal Medicine Clinic, Suite 4001, Ypsilanti, MI 48197-8633 | 2020-07-17 |
| 1790313849 | Cynthia Elizabeth Tetreault | Student in an Organized Health Care Education/Training Program | 5333 Mcauley Drive, Suite 2120, Ypsilanti, MI 48197-8633 | 2020-04-01 |
| 1144861527 | Naiomi C Wilson | Student in an Organized Health Care Education/Training Program | 4910 Sycamore Dr, Ypsilanti, MI 48197-6107 | 2019-10-07 |
| 1881157311 | Tobias Philip Keeney-bonthrone | Student in an Organized Health Care Education/Training Program | Academic Surgery Clinic, 5333 Mcauley Drive, Suite 2115, Ypsilanti, MI 48197-8633 | 2019-04-11 |
| 1417416298 | Justin Brewer | Student in an Organized Health Care Education/Training Program | 5333 Mcauley Drive Suite 2115, Ypsilanti, MI 48197 | 2019-03-19 |
| 1912499104 | Zachary Michael Vigliotti | Student in an Organized Health Care Education/Training Program | 413 W Forest Ave Apt 5, Ypsilanti, MI 48197-8141 | 2018-06-04 |
| 1134625585 | Carter Burson Anderson | Student in an Organized Health Care Education/Training Program | Academic Ob/gyn Clinic, 5333 Mcauley Drive, Suite 2110, Ypsilanti, MI 48197-8633 | 2018-04-04 |
| 1841795556 | Ann Elizabeth Hutchison | Student in an Organized Health Care Education/Training Program | 5333 Mcauley Dr Rm 2115, Ypsilanti, MI 48197-1097 | 2018-03-26 |
| 1720582794 | Angela Miciura | Student in an Organized Health Care Education/Training Program | 5333 Mcauley Dr Rm 2215, Ypsilanti, MI 48197-1097 | 2018-03-22 |
| Find all providers in YPSILANTI | ||||
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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.