NPIMap

Organization Active NPI

Pioneer Medical Associates P.C.

  • Internal Medicine Physician
  • Clinton TWP, MI
National Provider Identifier
1093296592
Registry record updated May 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PIONEER MEDICAL ASSOCIATES P.C.
Practice address
15945 19 Mile Rd Ste 204
Clinton TWP, MI 48038-1147
Phone
(586) 757-6400
NPI assigned
Aug 23, 2018
Last updated
May 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2023

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

Authorized official

Name
Ghaith Ibrahim, M.D.NPI 1932113438
Title
President
Phone
(586) 757-6400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary
Cardiovascular Disease Physician 207RC0000X
Endocrinology, Diabetes & Metabolism Physician 207RE0101X
Gastroenterology Physician 207RG0100X
Anatomic Pathology Physician 207ZP0101X
Neurology Physician 2084N0400X
Nurse Practitioner 363L00000X

Addresses

Primary practice location

15945 19 Mile Rd Ste 204
Clinton TWP, MI 48038-1147

Mailing address

PO Box 1000
Sterling Heights, MI 48311-1000
Phone (586) 771-0270

Other practice location 1

27560 Hoover Rd
Warren, MI 48093
Phone (586) 757-6400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180924001024 MI Part B Supplier - Clinic/Group Practice 2860743309 Receives reassigned benefits from 30 practitioners
1 other NPI on this enrollment
Practice locations: Clinton TWP, MI; Warren, MI; Saint Clair Shores, MI; Harper Woods, MI; Clinton Township, MI

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1534982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685404800000",
    "number": "1093296592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1000",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483111000",
            "telephone_number": "586-771-0270",
            "fax_number": "586-343-8870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15945 19 MILE RD STE 204",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480381147",
            "telephone_number": "586-757-6400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27560 Hoover Rd",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "MI",
            "postal_code": "48093",
            "country_code": "US",
            "telephone_number": "586-757-6400",
            "fax_number": "586-757-8400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PIONEER MEDICAL ASSOCIATES P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-23",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "GHAITH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-757-6400",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton TWP, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.