Individual provider Active NPI

Emad Nakkash, MD

  • Ophthalmology Physician
  • Hazel Park, MI
National Provider Identifier
1003899774
Registry record updated Dec 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
4301064463 Issued in MI
Practice address
22039 John R Rd
Hazel Park, MI 48030-1712
Phone
(248) 336-3937
Fax
(248) 336-3938
NPI assigned
Nov 27, 2005
Last updated
Dec 20, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 4301064463 MI Primary
Optometrist 152W00000X 4301064463 MI

Addresses

Primary practice location

22039 John R Rd
Hazel Park, MI 48030-1712

Mailing address

22039 John R Rd
Hazel Park, MI 48030-1712
Phone (248) 336-3937

Other identifiers 1

IdentifierTypeStateIssuer
4333900MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050105000468 MI Practitioner - Ophthalmology 1254389596 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Wayne State University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

22039 John R Rd
Hazel Park, MI 48030-1712
Phone (248) 336-3937

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.96 of 100Reported as group
Quality
83.68
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery69
Melanoma (skin cancer) excision14
Removal of skin lesions13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Emad Nakkash, MD, PC Optometrist CurrentSince Jul 20, 2001 Accepting new patients
Our Healthy Eyes PC Optometrist CurrentSince Oct 1, 2016 Accepting new patients
Northwest Eye Foundation Ophthalmology Past Accepting new patients
Eyes on Health PC Optometrist PastSince May 13, 2014 Accepting new patients

Locations

22039 John R Rd
Hazel Park, MI 48030
Phone (248) 336-3937

3080 John R Rd
Rochester Hills, MI 48307
Phone (248) 299-3937

Interoperability endpoints

  • Direct secure messaging: enakkash@direct.dmc.org
  • Direct secure messaging: emad.nakkash.1@11987.direct.athenahealth.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482192000000",
    "number": "1003899774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22039 JOHN R RD",
            "city": "HAZEL PARK",
            "state": "MI",
            "postal_code": "480301712",
            "telephone_number": "248-336-3937",
            "fax_number": "248-336-3938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22039 JOHN R RD",
            "city": "HAZEL PARK",
            "state": "MI",
            "postal_code": "480301712",
            "telephone_number": "248-336-3937",
            "fax_number": "248-336-3938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAKKASH",
        "first_name": "EMAD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-27",
        "last_updated": "2016-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "4301064463",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4301064463",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4333900",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazel Park, MI

Sources for this page

Verify at the official NPI Registry.