Individual provider Active NPI

Mudassir Ali Daimee, M.D.

  • Internal Medicine Physician
  • Troy, MI
National Provider Identifier
1205838307
Registry record updated Oct 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301076708 Issued in MI
Practice address
4967 Crooks Rd
Ste 130
Troy, MI 48098-5801
Phone
(248) 952-1601
Fax
(248) 952-0192
NPI assigned
Jun 2, 2005
Last updated
Oct 16, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301076708 MI Primary
Hospitalist Physician 208M00000X 4301076708 MI

Addresses

Primary practice location

4967 Crooks Rd
Ste 130
Troy, MI 48098-5801

Mailing address

4967 Crooks Rd
Ste 130
Troy, MI 48098-5801
Phone (248) 952-1601

Other identifiers 4

IdentifierTypeStateIssuer
1205838307OtherMINPI #
70-0-F32947-0OtherMIBCBS CPIN #
MD076708OtherMIBCBSM
4846342MedicaidMI

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)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Hospitalists, PC Past Accepting new patients
Michigan Hospitalists, PC Internal Medicine Past Accepting new patients

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": "1117670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192492800000",
    "number": "1205838307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4967 CROOKS RD",
            "address_2": "STE 130",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480985801",
            "telephone_number": "248-952-1601",
            "fax_number": "248-952-0192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4967 CROOKS RD",
            "address_2": "STE 130",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480985801",
            "telephone_number": "248-952-1601",
            "fax_number": "248-952-0192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAIMEE",
        "first_name": "MUDASSIR",
        "middle_name": "ALI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-02",
        "last_updated": "2007-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301076708",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MI",
            "license": "4301076708",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI #",
            "identifier": "1205838307",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS CPIN #",
            "identifier": "70-0-F32947-0",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "MD076708",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4846342",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; 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.