Active NPI
Julia Aseel Haidar, MD
- Student in an Organized Health Care Education/Training Program
- Ypsilanti, MI
National Provider Identifier
1104500883
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230707000915 | MI | Order and Referring Only - Family Practice | 4688033756 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4351052020 | MI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regents of the University of Michigan | Past | 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.
-
- Specialty Pharmacy
- Dexter, MI
- NPI 1952181919
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.