Individual provider Active NPI

Elwaleed Elhassan, MD MBBS FACP

  • Nephrology Physician
  • Detroit, MI
National Provider Identifier
1265673453
Registry record updated May 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
4301101789 Issued in MI
Practice address
4160 John R St
Suite 917
Detroit, MI 48201-2020
Phone
(313) 745-4525
Fax
(313) 745-0011
NPI assigned
Mar 17, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301101789 MI
Hypertension Specialist Physician 207RH0005X 4301101789 MI
Nephrology Physician 207RN0300X 4301101789 MI Primary

Addresses

Primary practice location

4160 John R St
Suite 917
Detroit, MI 48201-2020

Mailing address

1560 E Maple Rd
Suite 400-Credentialing
Troy, MI 48083-1138
Phone (313) 745-4525

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

NPI Registry JSON

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

{
    "created_epoch": "1237248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430438400000",
    "number": "1265673453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 E MAPLE RD",
            "address_2": "SUITE 400-CREDENTIALING",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831138",
            "telephone_number": "313-745-4525",
            "fax_number": "313-745-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 JOHN R ST",
            "address_2": "SUITE 917",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012020",
            "telephone_number": "313-745-4525",
            "fax_number": "313-745-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELHASSAN",
        "first_name": "ELWALEED",
        "name_prefix": "Dr.",
        "credential": "MD MBBS FACP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-17",
        "last_updated": "2015-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301101789",
            "primary": false
        },
        {
            "code": "207RH0005X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hypertension Specialist",
            "state": "MI",
            "license": "4301101789",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MI",
            "license": "4301101789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2015; 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.