MINA HAFZALAH (M.D.) – Pediatric Critical Care Medicine Physician, NPI 1083866107
Pediatric Critical Care Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,204 PEDIATRIC MEDICINE in MI
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Provider Addresses for MINA HAFZALAH (M.D.)
Children's Hospital of Michigan, 3901, Beaubien Street, Midtown, Detroit, Wayne County, Michigan, 48201, United States
DETROIT, MI 482012119
Phone: (313) 745-5629
Fax: (313) 966-0105
Type: Location
4201 ST. ANTOINE
UHC 5D - MAILBOX 226
DETROIT, MI 482012153
Phone: (313) 966-5051
Fax: (313) 966-0665
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2020-08-26
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20150910001871 | I | Critical Care (Intensivists) | IL | TBD |
| I20200826002616 | I | Pediatric Medicine | MI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 48201)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Pediatric Medicine | MI | |
| Pediatric Medicine | MI | |
| Pediatric Medicine | OH | |
| Pediatric Medicine | MI | |
| Pediatric Medicine | MI | |
| Nurse Practitioner | MI | |
| - | MI | |
| Nephrology, Pediatric Medicine | MI | |
| - | MI | |
| Pediatric Medicine | TN |
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