Lakeview Medical Center PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

LAKEVIEW MEDICAL CENTER PC

Practice address

23600 Harper Ave
Ste. 103
Saint Clair Shores, MI 48080-1445

Phone

(586) 585-2570

Fax

(586) 585-2574

NPI assigned

Apr 16, 2010

Last updated

Apr 16, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Magdy Wanis, MDNPI 1346353224

Title

Owner

Phone

(586) 585-2570

Specialties & licenses 1

Addresses

Other identifiers 9

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Magdy George Wanis, MD

  • Internal Medicine Physician
  • Saint Clair Shores, MI
  • NPI 1346353224
  Medicare reassignment NPD Authorized official
• Mona Y Wissa, NP

  • Gerontology Nurse Practitioner
  • Sterling Heights, MI
  • NPI 1043971369
  Medicare reassignment NPD
• Rachel Kloski, PA

  • Physician Assistant
  • Warren, MI
  • NPI 1558149070
  Medicare reassignment
• Mazin Mohi Deen, M.D.

  • Internal Medicine Physician
  • Roseville, MI
  • NPI 1740625508
  NPD (past)
• Mohanad Mohi Deen, MD

  • Student in an Organized Health Care Education/Training Program
  • Detroit, MI
  • NPI 1881258820
  NPD (past)
• Hilana Kaafarani, MD

  • Nephrology Physician
  • Roseville, MI
  • NPI 1174789473

  Internal Medicine

  NPD (past)
• Sabah M Mohammed, MD

  • Internal Medicine Physician
  • Roseville, MI
  • NPI 1366484206
  NPD (past)
• Majed A Rammouni, MD

  • Internal Medicine Physician
  • Saint Clair Shores, MI
  • NPI 1437262318
  NPD (past)
• Steven Robert Rogers, PA-C

  • Medical Physician Assistant
  • Roseville, MI
  • NPI 1386993509
  NPD (past)

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

{
    "created_epoch": "1271376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271376000000",
    "number": "1285950162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23600 HARPER AVE",
            "address_2": "STE. 103",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801445",
            "telephone_number": "586-585-2570",
            "fax_number": "586-585-2574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23600 HARPER AVE",
            "address_2": "STE. 103",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801445",
            "telephone_number": "586-585-2570",
            "fax_number": "586-585-2574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEVIEW MEDICAL CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-16",
        "last_updated": "2010-04-16",
        "status": "A",
        "authorized_official_last_name": "WANIS",
        "authorized_official_first_name": "MAGDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-585-2570",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLAN OF MICHIGAN",
            "identifier": "21969",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE CHOICES",
            "identifier": "127679",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "110500795-2",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P00051536",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN",
            "identifier": "P105025",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4243830",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID  FLORIDA",
            "identifier": "912517500",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAP",
            "identifier": "G89641",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7189170",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lakeshore Home Health Services, LLC
• Lakeshore Hospice, LLC
• Lakeshore Psychological Services
• Lakeside Internal Medicine PC
• Lakeview Diagnostic Services
• Lakeview Specialty Pharmacy Inc
• Meghan Lakosky
• Thomas Alexander Lalonde, MD
• Landra Prosthetics and Orthotics, Inc (Landra Prosthetics & Orthotics)
• Jessica Lynn Lane, CPNP-PC

• Internal Medicine Physician in Saint Clair Shores, MI
• Providers in Saint Clair Shores, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.