Ijaz Ali, PHYSICIAN, M.D

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

4351053185 Issued in MI

Practice address

44405 Woodward Ave Trinity Health Oakland
Graduate Medical Education Dept.
Pontiac, MI 48341

Phone

(248) 858-6233

Fax

(248) 858-3244

NPI assigned

May 2, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1714608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1073360525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44405 WOODWARD AVE TRINITY HEALTH OAKLAND",
            "address_2": "GRADUATE MEDICAL EDUCATION DEPT.",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "48341",
            "telephone_number": "248-858-6233",
            "fax_number": "248-858-3244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44405 WOODWARD AVE TRINITY HEALTH OAKLAND",
            "address_2": "GRADUATE MEDICAL EDUCATION DEPT.",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "48341",
            "telephone_number": "248-858-6233",
            "fax_number": "248-858-3244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALI",
        "first_name": "IJAZ",
        "credential": "PHYSICIAN, M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-02",
        "last_updated": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4351053185",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gayle Marie Albritton, NP
• Kim Abbegail Tan Aldecoa
• Zoha Abdul Aleem, MD
• Erika Alexander, MA, LPC, CAC
• Humza Rehman Ali, DO
• Janice A Alias
• Alju Total Care, LLC
• Rama Aljundi, MD
• Abdulsalam Alkadhy
• Sai Santhosha Mrudula Alla, M.D.

• Student in an Organized Health Care Education/Training Program in Pontiac, MI
• Providers in Pontiac, MI by specialty
• Student in an Organized Health Care Education/Training Program in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.