Active NPI
Mohammad Nurul Amin, MD
- Pediatrics Physician
- Sylvan Lake, MI
National Provider Identifier
1083612840
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 4301048260
- Practice address
- 2157 Orchard Lake Drive
Sylvan Lake, MI 48320 - Phone
- (248) 857-7878
- Fax
- (248) 857-7888
- NPI assigned
- Jul 14, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MA048260 | MI | |
| General Practice Physician | 208D00000X | 4301048260 | MI | |
| Pediatrics Physician | 208000000X | 4301048260 | MI | Primary |
Addresses
Primary practice location
2157 Orchard Lake Drive
Sylvan Lake, MI 48320
Mailing address
2157 Orchard Lake Drive
Sylvan Lake, MI 48320
Phone (248) 857-7878
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3506305691 | Other | MI | BCBS IND |
| 1759477 | Medicaid | MI | |
| 1083612840 | Medicaid | MI |
Other names 1
- Mohammad Nurul Amin
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: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- Other, 1978
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2157 Orchard Lake Rd
Sylvan Lake, MI 48320-1749
Phone (248) 857-7878
Hospital & facility affiliations
- Beaumont Hospital Royal Oak
- Trinity Health Oakland Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA048260 | MI | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michigan Family Medicine, PLLC | Family Medicine | Current | Accepting new patients |
| Michigan Family Medicine PLLC | Family Medicine | Current | Accepting new patients |
| Healing Hands Urgent Care Medical Clinic PC | Pediatrics | Current | Accepting new patients |
Interoperability endpoints
- mohammad.amin@hhucmcp-mi.direct.office.nextgen.com
Organizations & group practices 4
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.
-
- Family Medicine Physician
- Sylvan Lake, MI
- NPI 1912710609
Family Medicine, MI
-
- Pediatrics Physician
- Sylvan Lake, MI
- NPI 1780988493
Pediatrics
-
- Family Medicine Physician
- Sylvan Lake, MI
- NPI 1952106825
Family Medicine
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": "1121299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620000000000",
"number": "1083612840",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2157 ORCHARD LAKE DRIVE",
"city": "SYLVAN LAKE",
"state": "MI",
"postal_code": "48320",
"telephone_number": "248-857-7878",
"fax_number": "248-857-7888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2157 ORCHARD LAKE DRIVE",
"city": "SYLVAN LAKE",
"state": "MI",
"postal_code": "48320",
"telephone_number": "248-857-7878",
"fax_number": "248-857-7888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMIN",
"first_name": "MOHAMMAD",
"middle_name": "NURUL",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-14",
"last_updated": "2021-05-03",
"certification_date": "2021-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MI",
"license": "MA048260",
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "MI",
"license": "4301048260",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MI",
"license": "4301048260",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS IND",
"identifier": "3506305691",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1759477",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1083612840",
"state": "MI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MOHAMMAD",
"last_name": "AMIN",
"middle_name": "NURUL",
"credential": "MD",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Sylvan Lake, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2021; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.