NPIMap

Individual provider Active NPI

Mohammad Nurul Amin, MD

  • Pediatrics Physician
  • Sylvan Lake, MI
National Provider Identifier
1083612840
Registry record updated May 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301048260 Issued in MI
Practice address
2157 Orchard Lake Drive
Sylvan Lake, MI 48320
Phone
(248) 857-7878
Fax
(248) 857-7888
NPI assigned
Jul 14, 2005
Last updated
May 3, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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 names 1

  • Mohammad Nurul Amin Professional name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20081029000894 MI Practitioner - Pediatric MedicinePractitioner - General PracticePractitioner - Other (Physician) 7113829482 Reassigns benefits to 1 organization
I20250529003937 MI Practitioner - Family Practice 7113829482 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: General Practice
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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA048260MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Hands Urgent Care Medical Clinic PC Pediatrics Current Accepting new patients
Michigan Family Medicine, PLLC Family Medicine CurrentSince May 5, 2025 Accepting new patients
Michigan Family Medicine PLLC Family Medicine CurrentSince Jun 1, 2025 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: 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, 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": "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": [],
    "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

Verify at the official NPI Registry.