Individual provider Active NPI

Ahmed Rezk

  • Family Nurse Practitioner
  • Southfield, MI
National Provider Identifier
1154980134
Registry record updated Jun 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704279530 Issued in MI
Practice address
29877 Telegraph Rd Ste 301
Southfield, MI 48034-7660
Phone
(248) 359-2370
NPI assigned
Jun 12, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704279530 MI Primary

Addresses

Primary practice location

29877 Telegraph Rd Ste 301
Southfield, MI 48034-7660

Mailing address

7634 N Charlesworth St
Dearborn Heights, MI 48127-1614
Phone (248) 228-7772

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4704279530MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mindlin-Koh Center for Ophthalmic Medicine and Surgery PC Past Accepting new patients
Nephron Associates, PC PastSince Apr 1, 1999 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: arezk604844@direct.hfhs.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1154980134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7634 N CHARLESWORTH ST",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481271614",
            "telephone_number": "248-228-7772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29877 TELEGRAPH RD STE 301",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480347660",
            "telephone_number": "248-359-2370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REZK",
        "first_name": "AHMED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-12",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704279530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.