Active NPI
Wisam Alqazzaz
- Non-emergency Medical Transport (VAN)
- Dearborn Heights, MI
National Provider Identifier
1285428912
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Non-emergency Medical Transport (VAN)
- License
- 5802020115
- Practice address
- PO Box 310
Dearborn Heights, MI 48127-0310 - Phone
- (562) 213-5621
- NPI assigned
- Apr 7, 2025
- Last updated
- Apr 30, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Non-emergency Medical Transport (VAN) | 343900000X | 5802020115 | MI | Primary |
| Private Vehicle | 347C00000X | |||
| Lodging Provider | 177F00000X | |||
| Mail Order Pharmacy | 3336M0002X | |||
| Meals Provider | 174200000X |
Addresses
Primary practice location
PO Box 310
Dearborn Heights, MI 48127-0310
Mailing address
PO Box 310
Dearborn Heights, MI 48127-0310
Phone (562) 213-5621
Other practice location 1
PO Box 64
Sterling Heights, MI 48311-0064
Phone (561) 543-2792
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5802020115 | MI | MD | Non-emergency Medical Transport (VAN) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1743984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745971200000",
"number": "1285428912",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 310",
"city": "DEARBORN HEIGHTS",
"state": "MI",
"postal_code": "481270310",
"telephone_number": "562-213-5621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PO BOX 310",
"city": "DEARBORN HEIGHTS",
"state": "MI",
"postal_code": "481270310",
"telephone_number": "562-213-5621"
}
],
"practiceLocations": [
{
"address_1": "PO Box 64",
"address_purpose": "LOCATION",
"city": "Sterling Heights",
"state": "MI",
"postal_code": "483110064",
"country_code": "US",
"telephone_number": "561-543-2792",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ALQAZZAZ",
"first_name": "WISAM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-04-07",
"last_updated": "2025-04-30",
"certification_date": "2025-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "343900000X",
"taxonomy_group": "",
"desc": "Non-emergency Medical Transport (VAN)",
"state": "MI",
"license": "5802020115",
"primary": true
},
{
"code": "347C00000X",
"taxonomy_group": "",
"desc": "Private Vehicle",
"state": null,
"license": null,
"primary": false
},
{
"code": "177F00000X",
"taxonomy_group": "",
"desc": "Lodging",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336M0002X",
"taxonomy_group": "",
"desc": "Pharmacy, Mail Order Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "174200000X",
"taxonomy_group": "",
"desc": "Meals",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dearborn Heights, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.