Individual provider Active NPI

Batoul Bayram, AGPCNP

  • Nurse Practitioner
  • Dearborn Heights, MI
National Provider Identifier
1053290395
Registry record updated Aug 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704323649NSA250PK Issued in MI
Practice address
21018 Fairview Dr
Dearborn Heights, MI 48127-2645
Phone
(313) 415-5595
NPI assigned
Aug 30, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X 4704323649NSA250PK MI Primary

Addresses

Primary practice location

21018 Fairview Dr
Dearborn Heights, MI 48127-2645

Mailing address

21018 Fairview Dr
Dearborn Heights, MI 48127-2645
Phone (313) 415-5595

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251226001978 MI Practitioner - Nurse Practitioner 7719473982 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5250 Auto Club Dr
Suite 200
Dearborn, MI 48126-2619

5250 Auto Club Dr
Suite 200
Dearborn, MI 48126-4212

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704323649NSA250PKMIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alzohaili Medical Consultants MD PC Single Specialty CurrentSince Nov 1, 2025 Accepting new patients

Locations

5250 Auto Club Dr
Ste 200
Dearborn, MI 48126
Phone (313) 203-5300

5220 Oakman Blvd
Dearborn, MI 48126
Phone (313) 203-5300

Organizations & group practices 1

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": "1756512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756512000000",
    "number": "1053290395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21018 FAIRVIEW DR",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481272645",
            "telephone_number": "313-415-5595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21018 FAIRVIEW DR",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481272645",
            "telephone_number": "313-415-5595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAYRAM",
        "first_name": "BATOUL",
        "credential": "AGPCNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-30",
        "last_updated": "2025-08-30",
        "certification_date": "2025-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704323649NSA250PK",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn Heights, MI

Sources for this page

Verify at the official NPI Registry.