Individual provider Active NPI

Abubaker Ahmed Ali, M.D.

  • Surgery Physician
  • Palm Coast, FL
National Provider Identifier
1063640068
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME167068 Issued in FL
Practice address
61 Memorial Medical Pkwy Ste 1-800a
Palm Coast, FL 32164-5983
Phone
(386) 302-1366
NPI assigned
Jun 29, 2009
Last updated
Aug 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 4301094760 MI
Surgery Physician 208600000X ME167068 FL Primary

Addresses

Primary practice location

61 Memorial Medical Pkwy Ste 1-800a
Palm Coast, FL 32164-5983

Mailing address

PO Box 946383
Atlanta, GA 30394-6383

Other practice location 1

13051 Osborne St
Apt 608
Dearborn, MI 48126-4037
Phone (313) 878-7575

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, MI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150804006242 FL Practitioner - General Surgery 3678887676 Reassigns benefits to 1 organization
I20160909000219 MI Practitioner - General Surgery 3678887676 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Healthcare Partners, IncGroup PAC ID 7012266836, 621 clinicians

Practice addresses (Care Compare)

60 Memorial Medical Pkwy
Palm Coast, FL 32164-5980
Phone (386) 586-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.26 of 100Reported as group
Quality
64.16
Promoting interoperability
100
Improvement activities
40
Cost
73.79

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)18
Upper gastrointestinal (GI) endoscopy for acid reflux14
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
VHS Physicians of Michigan CurrentSince Sep 19, 2016 Accepting new patients
Kemit PLLC CurrentSince Sep 19, 2016 Accepting new patients
Memorial Hospital Flagler Inc. CurrentSince Jun 15, 2024 Accepting new patients
Memorial Hospital Flagler Inc CurrentSince Jun 15, 2024 Accepting new patients
Florida Hospital Healthcare Partners, Inc Surgery CurrentSince Jun 15, 2024 Accepting new patients
United Trauma Care PLC CurrentSince Jan 1, 2017 Accepting new patients
Adventhealth Primary Care Network Inc Past Accepting new patients

Locations

1055 Saxon Blvd
Orange City, FL 32763
Phone (386) 917-5000

120 Cypress Edge Dr
Ste 102
Palm Coast, FL 32164
Phone (386) 586-4280

120 Cypress Edge Dr
Ste 210
Palm Coast, FL 32164
Phone (386) 445-4750

3 Adventhealth Way
Ste 201
Palm Coast, FL 32137
Phone (386) 586-1840

60 Memorial Medical Pkwy
Palm Coast, FL 32164
Phone (385) 586-2000

61 Memorial Medical Pkwy
Ste 1-800A
Palm Coast, FL 32164
Phone (386) 586-1810

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

6071 W Outer Dr
Detroit, MI 48235
Phone (313) 966-3300

23077 Greenfield Rd
Ste 231
Southfield, MI 48075
Phone (248) 569-2160

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: aali2962884@adventhealth.direct-ci.com

Organizations & group practices 7

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 4

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": "1246233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1063640068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 946383",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303946383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 MEMORIAL MEDICAL PKWY STE 1-800A",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321645983",
            "telephone_number": "386-302-1366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13051 Osborne St",
            "address_2": "APT 608",
            "address_purpose": "LOCATION",
            "city": "Dearborn",
            "state": "MI",
            "postal_code": "481264037",
            "country_code": "US",
            "telephone_number": "313-878-7575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALI",
        "first_name": "ABUBAKER",
        "middle_name": "AHMED",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-29",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301094760",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME167068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Coast, FL

Sources for this page

Verify at the official NPI Registry.