Aldad Medical PC
Organization Active NPI Psychiatry Physician · Detroit, MI
NPI 1154088771 · NPPES record last updated Mar 28, 2023
Key facts
- NPI
- 1154088771
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatry Physician 2084P0800X
- Legal business name
- ALDAD MEDICAL PC
- Practice address
- 400 Renaissance Ctr Ste 2600
Detroit, MI 48243-1502 - Phone
- (516) 505-7200
- NPI assigned
- Nov 18, 2021
- Organization subpart
- No
Authorized official
- Name
- Tamir Aldad
- Title
- Ceo
- Phone
- (516) 505-7200
Other NPIs with the same Medicare PAC ID 4
Practitioners 16
-
Tamir Aldad, M.D.
-
Stacey Bishop, NP
-
Jenna Louise Chambless, PMHNP
-
Karolyn Rose Coulouris, PMHNP
-
Annette Mills-McCoy, LMSW-C
-
Holly Richard, MSN, APRN, PMHNP-BC
-
David Strunk, LLMSW
-
Molly Christensen, APRN, PMHNP-BC
-
Francisco Davila, LCSW
-
Alisha Martin, PMHNP-BC
-
Sara Missaoui, PHYSICIAN ASSISTANT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20211203001611 | MI | Part B Supplier - Clinic/Group Practice | 5395152201 |
Receives reassigned benefits from 11 practitioners Practice locations: Waterford, MI; Detroit, MI; Ann Arbor, MI |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician |
2084P0800X | Yes |
Addresses
Primary practice location
400 Renaissance Ctr Ste 2600
Detroit, MI 48243-1502
Mailing address
510 Hempstead Tpke RM 203
West Hempstead, NY 11552-1152
Phone (516) 505-7200
Other practice location 1
5800 Highland Rd
Waterford, MI 48327-1827
Phone (516) 505-7200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4301505906 | Other | MI | LICENSE |
Other providers in Detroit, MI
- Craig Albosta
- Ayman Alboudi
- Kamelia Albujoq
- Linda Mamdoh a Albusoul
- Jean Alce
- Saba Sabri Aldahan
- Shaima Aldaibil
- Melad Aldanal
- Barah Alden
- Allison Alderton
All providers in Detroit, MI · Psychiatry Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 28, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.