Individual provider Active NPI

Julia Aseel Haidar, MD

  • Student in an Organized Health Care Education/Training Program
  • Ypsilanti, MI
National Provider Identifier
1104500883
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
200 Arnet St Ste 200
Ypsilanti, MI 48198-5753
Phone
(734) 482-6221
NPI assigned
Jun 13, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4351052020 MI
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

200 Arnet St Ste 200
Ypsilanti, MI 48198-5753

Mailing address

14155 Terrace CT # 21
Plymouth, MI 48170-3755
Phone (313) 404-1536

Other practice location 1

14700 E Old US Highway 12
Chelsea, MI 48118-1185
Phone (734) 475-1321

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230707000915 MI Order and Referring Only - Family PracticePractitioner - Family Practice 4688033756

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4351052020MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of Michigan PastSince Jun 18, 2023 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1686614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1104500883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14155 TERRACE CT # 21",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481703755",
            "telephone_number": "313-404-1536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ARNET ST STE 200",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481985753",
            "telephone_number": "734-482-6221"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14700 E Old US Highway 12",
            "address_purpose": "LOCATION",
            "city": "Chelsea",
            "state": "MI",
            "postal_code": "481181185",
            "country_code": "US",
            "telephone_number": "734-475-1321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAIDAR",
        "first_name": "JULIA",
        "middle_name": "ASEEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-13",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4351052020",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.