Prohealth Clinic PLLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

PROHEALTH CLINIC PLLC

Practice address

8713 Joseph Campau St
Hamtramck, MI 48212-3720

Phone

(313) 455-6977

NPI assigned

Mar 29, 2019

Organization subpart

No

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

Authorized official

Name

Yaser Ali Fadel, MDNPI 1740800101

Title

Ceo

Phone

(313) 656-4748

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 6

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.

• Fikrat Barbour Kayali, M.D.

  • General Practice Physician
  • Dearborn, MI
  • NPI 1669449096

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Waleed Obaid, M.D

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1003187295
  Medicare reassignment Care Compare group
• Marium Mohammed Iqbal, MD

  • Pediatrics Physician
  • Taylor, MI
  • NPI 1134768336
  Medicare reassignment NPD
• Yaser Ali Fadel, MD

  • Family Medicine Physician
  • Alma, MI
  • NPI 1740800101
  NPD Authorized official
• Ashraf Ehab Mostafa, MD

  • Interventional Cardiology Physician
  • Lapeer, MI
  • NPI 1396976080
  Medicare reassignment
• Robert M Stein, DPM

  • Podiatrist
  • Hamtramck, MI
  • NPI 1144383704
  NPD (past)

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

{
    "created_epoch": "1553817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712966400000",
    "number": "1134680333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8713 JOSEPH CAMPAU ST",
            "city": "HAMTRAMCK",
            "state": "MI",
            "postal_code": "482123720",
            "telephone_number": "313-455-6977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8713 JOSEPH CAMPAU ST",
            "city": "HAMTRAMCK",
            "state": "MI",
            "postal_code": "482123720",
            "telephone_number": "313-455-6977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROHEALTH CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-29",
        "last_updated": "2024-04-13",
        "certification_date": "2024-04-13",
        "status": "A",
        "authorized_official_last_name": "FADEL",
        "authorized_official_first_name": "YASER",
        "authorized_official_middle_name": "ALI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "313-656-4748",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "OFFICE",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "8713 Joseph Campau St",
            "city": "Hamtramck",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482123720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Basil Azmi Abdulmuti Qandil, MD
• Lina Qasem, PHARMD

• Primary Care Clinic/Center in Hamtramck, MI
• Providers in Hamtramck, MI by specialty
• Primary Care Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.