NPIMap

Individual provider Active NPI

Moneer Al-Nabolsi

  • Family Medicine Physician
  • Novi, MI
National Provider Identifier
1144886409
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101026713 Issued in MI
Practice address
44130 W 12 Mile Rd
Novi, MI 48377-2614
Phone
(248) 380-8811
NPI assigned
May 13, 2019
Last updated
Jun 23, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101026713 MI Primary

Addresses

Primary practice location

44130 W 12 Mile Rd
Novi, MI 48377-2614

Mailing address

44130 W 12 Mile Rd
Novi, MI 48377-2614
Phone (313) 663-6315

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address malnabolsi958619@direct.beaumont.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220627002990 MI Practitioner - Family Practice 7214270545 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Oakwood Ambulatory LLCGroup PAC ID 1850282914, 271 clinicians

Practice addresses (Care Compare)

201 3Rd St
Suite 200
Belleville, MI 48111-2605
Phone (734) 697-9065

44130 W 12 Mile Rd
Corewell Health Farmington Hills Hospital F
Novi, MI 48377-2614
Phone (248) 380-8811

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101026713MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oakwood Ambulatory LLC Family Medicine CurrentSince Jul 25, 2022 Accepting new patients
Oakwood Ambulatory, LLC CurrentSince Jul 25, 2022 Accepting new patients
Botsford General Hospital Past Accepting new patients

Locations

201 3rd St
Ste 200
Belleville, MI 48111
Phone (734) 697-9065

28100 Grand River Ave
Ste 313
Farmington Hills, MI 48336
Phone (248) 615-7150

44130 W Twelve Mile Rd
Novi, MI 48377
Phone (248) 380-8811

Interoperability endpoints

  • Direct secure messaging: malnabolsi1222458@epic00.shdirect.org

Organizations & group practices 3

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.

Hospital & facility affiliations 11

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": "1557705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1144886409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44130 W 12 MILE RD",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483772614",
            "telephone_number": "313-663-6315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44130 W 12 MILE RD",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483772614",
            "telephone_number": "248-380-8811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL-NABOLSI",
        "first_name": "MONEER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-13",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101026713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "malnabolsi958619@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "44130 W 12 Mile Rd",
            "city": "Novi",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483772614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

Verify at the official NPI Registry.