Individual provider Active NPI

Saba Al-Qawasmi

  • Optometrist
  • Wayne, MI
National Provider Identifier
1013765452
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901005803 Issued in MI
Practice address
35169 E Michigan Ave
Wayne, MI 48184-1660
Phone
(734) 728-5940
NPI assigned
May 10, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901005803 MI Primary

Addresses

Primary practice location

35169 E Michigan Ave
Wayne, MI 48184-1660

Mailing address

41434 W Village Green Blvd Apt 201
Canton, MI 48187-3864
Phone (708) 745-8979

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250428002693 MI Practitioner - Optometry 0547786014 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4901005803MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
SVS Vision Inc Optometrist CurrentSince Feb 16, 2025 Accepting new patients
SVS Vision Inc Optometrist CurrentSince Feb 16, 2025 Accepting new patients

Locations

455 E Grand River Ave
Brighton, MI 48116
Phone (810) 227-2376

118 Cass Ave
Mount Clemens, MI 48043
Phone (586) 464-1479

10791 Belleville Rd
Van Buren Township, MI 48111
Phone (734) 391-3080

35169 E Michigan Ave
Wayne, MI 48184
Phone (734) 728-5940

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1715299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1013765452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41434 W VILLAGE GREEN BLVD APT 201",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481873864",
            "telephone_number": "708-745-8979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35169 E MICHIGAN AVE",
            "city": "WAYNE",
            "state": "MI",
            "postal_code": "481841660",
            "telephone_number": "734-728-5940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL-QAWASMI",
        "first_name": "SABA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-10",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901005803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, MI

Sources for this page

Verify at the official NPI Registry.