Individual provider Active NPI

Malak Abdallah, PA-C

  • Physician Assistant
  • Dearborn, MI
National Provider Identifier
1245922194
Registry record updated Jan 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
6500 Schaefer Rd
Dearborn, MI 48126-1813
Phone
(313) 584-7900
NPI assigned
May 22, 2023
Last updated
Jan 31, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary
Medical Physician Assistant 363AM0700X NU

Addresses

Primary practice location

6500 Schaefer Rd
Dearborn, MI 48126-1813

Mailing address

6500 Schaefer Rd
Dearborn, MI 48126-1813
Phone (313) 584-7900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231025001898 MI Practitioner - Physician Assistant 6901252055 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Michigan Medical School, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Slim Internal Medicine PLLCGroup PAC ID 6002116258, 3 clinicians
Patient First Medical Clinic PLLCGroup PAC ID 2567753700, 8 clinicians

Practice addresses (Care Compare)

24513 Ford Rd
Dearborn, MI 48128-1131
Phone (313) 791-7992

5479 Schaefer Rd
Dearborn, MI 48126-3222
Phone (313) 791-7992

6500 Schaefer Rd
Dearborn, MI 48126-1813

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Center Street Pharmacy PLLC PastSince Jul 9, 2025 Accepting new patients

Organizations & group practices 6

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": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1245922194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 SCHAEFER RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481261813",
            "telephone_number": "313-584-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 SCHAEFER RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481261813",
            "telephone_number": "313-584-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDALLAH",
        "first_name": "MALAK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-22",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.