NPIMap

Individual provider Active NPI

Amal Alqurneh

  • Family Medicine Physician
  • Romulus, MI
National Provider Identifier
1245720531
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101026194 Issued in MI
Practice address
12100 S Huron River Dr
Romulus, MI 48174-1119
Phone
(734) 941-1070
Fax
(734) 941-1763
NPI assigned
May 13, 2018
Last updated
Jul 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 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 5101026194 MI Primary

Addresses

Primary practice location

12100 S Huron River Dr
Romulus, MI 48174-1119

Mailing address

26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849

Other practice location 1

2050 N Haggerty Rd Ste 220
Canton, MI 48187-3796
Phone (734) 446-9757

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aalqurneh2124832@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
I20210827002045 MI Practitioner - Family Practice 2860748274 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
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

2050 N Haggerty Rd
Canton, MI 48187-3796

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101026194MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oakwood Ambulatory LLC Family Medicine CurrentSince Aug 26, 2021 Accepting new patients
Oakwood Ambulatory, LLC CurrentSince Aug 26, 2021 Accepting new patients

Locations

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

2050 N Haggerty Rd
Ste 220
Canton, MI 48187
Phone (734) 446-9757

12100 S Huron River Dr
Romulus, MI 48174
Phone (734) 941-1070

26901 Beaumont Blvd
Ste 3D
Southfield, MI 48033
Phone (947) 522-1860

Interoperability endpoints

  • Direct secure messaging: aalqurneh1223036@epic00.shdirect.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1526169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1245720531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12100 S HURON RIVER DR",
            "city": "ROMULUS",
            "state": "MI",
            "postal_code": "481741119",
            "telephone_number": "734-941-1070",
            "fax_number": "734-941-1763"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2050 N Haggerty Rd Ste 220",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "MI",
            "postal_code": "481873796",
            "country_code": "US",
            "telephone_number": "734-446-9757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALQURNEH",
        "first_name": "AMAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-13",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101026194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aalqurneh2124832@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "2050 N Haggerty Rd Ste 220",
            "city": "Canton",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481873796",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Romulus, MI

Sources for this page

Verify at the official NPI Registry.