Individual provider Active NPI

Ahmed I Jamalaldin, PTA

  • Physical Therapy Assistant
  • Farmington Hills, MI
National Provider Identifier
1043998198
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
5502006398 Issued in MI
Practice address
24100 Drake Rd Ste C
Farmington Hills, MI 48335-3155
Phone
(248) 516-3960
Fax
(248) 426-8646
NPI assigned
Jul 10, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 5502006398 MI Primary

Addresses

Primary practice location

24100 Drake Rd Ste C
Farmington Hills, MI 48335-3155

Mailing address

24100 Drake Rd Ste C
Farmington Hills, MI 48335-3155
Phone (248) 516-3960

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5502006398MIMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1043998198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24100 DRAKE RD STE C",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483353155",
            "telephone_number": "248-516-3960",
            "fax_number": "248-426-8646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24100 DRAKE RD STE C",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483353155",
            "telephone_number": "248-516-3960",
            "fax_number": "248-426-8646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAMALALDIN",
        "first_name": "AHMED",
        "middle_name": "I",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "5502006398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.