Nour Ali
Individual provider Active NPI Medical Physician Assistant · Brownstown TWP, MI
NPI 1104279512 · NPPES record last updated Jul 20, 2016
Key facts
- NPI
- 1104279512
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- Practice address
- 19145 Allen Rd
#107
Brownstown TWP, MI 48183-6812 - Phone
- (734) 486-4200
- NPI assigned
- Jul 20, 2016
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161104000703 | MI | Practitioner - Physician Assistant | 1951689355 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ppom | Past | Accepting new patients |
Interoperability endpoints
- nali1222772@epic00.shdirect.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | Yes |
Addresses
Primary practice location
19145 Allen Rd
#107
Brownstown TWP, MI 48183-6812
Mailing address
115 Lake Village Blvd
Apt 103
Dearborn, MI 48120-1665
Other providers in Brownstown TWP, MI
- Acredo Pharmacy LLC
- Acredo Pharmacy LLC
- Acredo Pharmacy LLC
- Alka Aggarwal
- Rola Ajami
- Alka D. Aggarwal MD PC
- Saba Alkhuzaee
- Alliance Physician Services of Michigan, P.C.
- Amini Healthcare PLLC
- Louis Andary Jr.
All providers in Brownstown TWP, MI · Medical Physician Assistant in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 20, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.