NPIMap

Individual provider Active NPI

Ibtihal Alghanimi

  • Acute Care Nurse Practitioner
  • Dearborn, MI
National Provider Identifier
1013671916
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
4704316053 Issued in MI
Practice address
5728 Schaefer Rd Ste 103
Dearborn, MI 48126-2287
Phone
(313) 581-8080
NPI assigned
Oct 26, 2021
Last updated
Oct 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 4704316053 MI Primary

Addresses

Primary practice location

5728 Schaefer Rd Ste 103
Dearborn, MI 48126-2287

Mailing address

205 N East Ave
Jackson, MI 49201-1753

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221213001442 MI Practitioner - Nurse Practitioner 7618346735 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providers Tek IncGroup PAC ID 2264792084, 13 clinicians

Practice addresses (Care Compare)

205 N E Ave
Henry Ford Allegiance Hospitalist Services
Jackson, MI 49201-1753
Phone (517) 205-1328

4700 Greenfield Rd
Suite 2E
Dearborn, MI 48126-4124
Phone (313) 740-1111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704316053MIMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ihp Hospital Medicine - Jackson PLLC CurrentSince Mar 19, 2024 Accepting new patients
W.a. Foote Memorial Hospital Acute Care CurrentSince Dec 8, 2022 Accepting new patients
Riverview Neuromuscular Pain Center PLLC CurrentSince Dec 1, 2024 Accepting new patients
W.a. Foote Memorial Hospital CurrentSince Dec 8, 2022 Accepting new patients
W.a. Foote Memorial Hospital, Inc Current Accepting new patients
Providers Tek Inc. CurrentSince Dec 1, 2024 Accepting new patients
Independent Observation Physicians PLLC CurrentSince Oct 29, 2023 Accepting new patients
Iep Observation Medicine - Jackson PLLC CurrentSince Mar 3, 2024 Accepting new patients
W.a. Foote Memorial Hospital Past Accepting new patients

Locations

4700 Greenfield Rd
Ste 2E
Dearborn, MI 48126
Phone (313) 740-1111

1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-4806

7633 E Jefferson Ave
Ste 170
Detroit, MI 48214
Phone (313) 401-0256

37000 Grand River Ave
Ste 310
Farmington Hills, MI 48335
Phone (913) 223-0811

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

813 W Michigan Ave
Jackson, MI 49202
Phone (517) 205-1000

47601 Grand River Ave
Novi, MI 48374
Phone (248) 465-4100

16001 W 9 Mile Rd
Southfield, MI 48075
Phone (248) 424-3000

7845 Spring Arbor Rd
Spring Arbor, MI 49283
Phone (517) 205-2580

Interoperability endpoints

  • Direct secure messaging: ialghanimi747626@direct.hfhs.org

Organizations & group practices 9

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 6

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": "1635206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1013671916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 N EAST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5728 SCHAEFER RD STE 103",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262287",
            "telephone_number": "313-581-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALGHANIMI",
        "first_name": "IBTIHAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-26",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704316053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.