Individual provider Active NPI

Abdul Malik Qavi, D.O.

  • Internal Medicine Physician
  • Detroit, MI
National Provider Identifier
1124448113
Registry record updated Mar 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
34012967 Issued in OH
Practice address
3031 W Grand Blvd
Suite 450
Detroit, MI 48202-3046
Phone
(586) 258-8169
NPI assigned
Apr 17, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 34012967 OH Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

3031 W Grand Blvd
Suite 450
Detroit, MI 48202-3046

Mailing address

8167 Bay CT
Temperance, MI 48182-9157

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20170814001188 OH Practitioner - HospitalistPractitioner - Internal Medicine 6406127299 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Apogee Medical Group Ohio IncGroup PAC ID 8224082292, 45 clinicians

Practice addresses (Care Compare)

2420 Lake Ave
Ashtabula, OH 44004-4954
Phone (440) 997-6328

Hospital & facility affiliations

  • Ashtabula County Medical Center Hospital, Ashtabula, OH, CCN 360125
  • Hillcrest Hospital Hospital, Mayfield Heights, OH, CCN 360230

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34012967OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of Ohio, Professional Corporation Internal Medicine CurrentSince Jul 5, 2017 Accepting new patients
Ashtabula County Medical Center CurrentSince Feb 17, 2019 Accepting new patients
Apogee Medical Group Ohio Inc Internal Medicine CurrentSince Jul 1, 2020 Accepting new patients
Hospitalist Medicine Physicians of Richland County, LTD Internal Medicine CurrentSince May 13, 2022 Accepting new patients
Ashtabula County Medical Center Past Accepting new patients

Locations

1 Akron General Ave
Akron, OH 44307
Phone (330) 344-5760

2420 Lake Ave
Ashtabula, OH 44004
Phone (216) 986-2919

1320 Timken Mercy Dr NW
Canton, OH 44708
Phone (330) 489-1000

1805 27th St
Portsmouth, OH 45662
Phone (740) 356-5000

1044 Belmont Ave
Youngstown, OH 44504
Phone (330) 480-2182

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1397692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552953600000",
    "number": "1124448113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8167 BAY CT",
            "city": "TEMPERANCE",
            "state": "MI",
            "postal_code": "481829157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3031 W GRAND BLVD",
            "address_2": "SUITE 450",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023046",
            "telephone_number": "586-258-8169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QAVI",
        "first_name": "ABDUL",
        "middle_name": "MALIK",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-17",
        "last_updated": "2019-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "34012967",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.