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
Mailing address49409 W Central Park, Shelby Twp, MI 48317-6355

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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