Individual provider Active NPI

Yathreb Alaali

  • Internal Medicine Physician
  • Detroit, MI
National Provider Identifier
1144536319
Registry record updated Dec 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
E-10105 Issued in AR
Practice address
2799 W. Grand Blvd
Detroit, MI 48202
Phone
(313) 916-2600
NPI assigned
Aug 26, 2010
Last updated
Dec 15, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X E-10105 AR Primary

Addresses

Primary practice location

2799 W. Grand Blvd
Detroit, MI 48202

Mailing address

1601 W 40TH Ave
Ste 301
Pine Bluff, AR 71603-6346
Phone (313) 916-2600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20170105000142 AR Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 6406088731 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-10105ARMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Health Group CurrentSince Aug 1, 2020 Accepting new patients
Arkansas Health Group CurrentSince Aug 1, 2020 Accepting new patients

Locations

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

3201 Springhill Dr
Ste 350
North Little Rock, AR 72117
Phone (501) 945-0392

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1282780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481760000000",
    "number": "1144536319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 W 40TH AVE",
            "address_2": "STE 301",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716036346",
            "telephone_number": "313-916-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W. GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48202",
            "telephone_number": "313-916-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALAALI",
        "first_name": "YATHREB",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-26",
        "last_updated": "2016-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E-10105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.