Organization Active NPI

Downriver Specialists, P.C.

  • Internal Medicine Physician
  • Brownstown TWP, MI
National Provider Identifier
1023044542
Registry record updated Oct 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
DOWNRIVER SPECIALISTS, P.C.
Practice address
19727 Allen Rd
Ste 12
Brownstown TWP, MI 48183-1188
Phone
(734) 479-8000
Fax
(734) 479-4812
NPI assigned
Jun 25, 2006
Last updated
Oct 29, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2007

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

Authorized official

Name
Dr. Iqbal A Nasir, M.D.NPI 1477523439
Title
President
Phone
(734) 479-8000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

19727 Allen Rd
Ste 12
Brownstown TWP, MI 48183-1188

Mailing address

19727 Allen Rd
Ste 12
Brownstown TWP, MI 48183-1188
Phone (734) 479-8000

Other identifiers 3

IdentifierTypeStateIssuer
4978136MedicaidMI
4978127MedicaidMI
4978109MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061110000223 MI Part B Supplier - Clinic/Group Practice 1052319811 Receives reassigned benefits from 6 practitioners
Practice locations: Woodhaven, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193616000000",
    "number": "1023044542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19727 ALLEN RD",
            "address_2": "STE 12",
            "city": "BROWNSTOWN TWP",
            "state": "MI",
            "postal_code": "481831188",
            "telephone_number": "734-479-8000",
            "fax_number": "734-479-4812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19727 ALLEN RD",
            "address_2": "STE 12",
            "city": "BROWNSTOWN TWP",
            "state": "MI",
            "postal_code": "481831188",
            "telephone_number": "734-479-8000",
            "fax_number": "734-479-4812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOWNRIVER SPECIALISTS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2007-10-29",
        "status": "A",
        "authorized_official_last_name": "NASIR",
        "authorized_official_first_name": "IQBAL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "734-479-8000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4978136",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4978127",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4978109",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownstown TWP, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.