Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jaina Sabu Samuel

Individual provider Medical-Surgical Registered Nurse · NPI 1003379314

Jaina Sabu Samuel is a Nurse Practitioner in Detroit, Michigan. Qualified in 2021, 5 years ago. Practices with Henry Ford Health St John Hospital, a 330-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
5
Licensed in
MI
In the registry since
2019
Specialties on file
2
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Practice location Address checks out

22101 Moross Rd
Detroit, MI 48236-2148
Phone: (313) 343-4000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 4704247931 (MI)
Medical-Surgical Registered Nurse Taxonomy 163WM0705X · Licence 4704247931 (MI)

Record details

NPI number1003379314
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 12, 2019
Last updated in NPPESApril 3, 2024
Certification dateApril 3, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Henry Ford Health St. John Hospital — 330 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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