Organization Active NPI

Asthma, Allergy and Sinus Center, PC

  • Allergy Physician
  • Sandusky, MI
National Provider Identifier
1093720740
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
Legal business name
ASTHMA, ALLERGY AND SINUS CENTER, PC
Practice address
115 N Delaware St
Sandusky, MI 48471-1008
Phone
(810) 648-4544
Fax
(810) 648-5924
NPI assigned
Jul 30, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mutee Abdeljaber, M.D.NPI 1457382939
Title
Owner
Phone
(810) 648-4544

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X NU Primary

Addresses

Primary practice location

115 N Delaware St
Sandusky, MI 48471-1008

Mailing address

PO Box 1108
Attn: Lynda Thompson
Ann Arbor, MI 48106-1108
Phone (734) 677-7400

Other identifiers 1

IdentifierTypeStateIssuer
CJ8012OtherMIRR MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040422000887 MI Part B Supplier - Clinic/Group Practice 4587658455 Receives reassigned benefits from 1 practitioner
Practice locations: Sandusky, MI; Mount Pleasant, MI; Lapeer, MI; Gladwin, MI; Caro, MI; Grand Blanc, MI

National Provider Directory

National Provider Directory

Locations

1040 S Van Dyke Rd
Ste 2
Bad Axe, MI 48413
Phone (517) 269-5102

634 N State St
Caro, MI 48723
Phone (989) 672-0092

1260 N Irish Rd
Davison, MI 48423
Phone (810) 653-1400

110 Buckeye St
Gladwin, MI 48624
Phone (989) 426-9399

1426 N State St
Gladwin, MI 48624
Phone (989) 426-0169

1075 Suncrest Dr
Lapeer, MI 48446
Phone (810) 245-9700

944 Baldwin Rd
Ste B
Lapeer, MI 48446
Phone (810) 245-9600

1201 South Dr
Mt Pleasant, MI 48858
Phone (989) 772-6880

1970 Ashland Dr
Mt Pleasant, MI 48858
Phone (517) 466-3215

1209 10th St
Port Huron, MI 48060
Phone (810) 985-8170

100 W Argyle St
#4
Sandusky, MI 48471
Phone (810) 648-3770

Practitioners & affiliated clinicians

Practitioners 24

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 24

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093720740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1108",
            "address_2": "ATTN: LYNDA THOMPSON",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481061108",
            "telephone_number": "734-677-7400",
            "fax_number": "734-677-7407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 N DELAWARE ST",
            "city": "SANDUSKY",
            "state": "MI",
            "postal_code": "484711008",
            "telephone_number": "810-648-4544",
            "fax_number": "810-648-5924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASTHMA, ALLERGY AND SINUS CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ABDELJABER",
        "authorized_official_first_name": "MUTEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "810-648-4544",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CJ8012",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandusky, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.