Individual provider Active NPI

Mustafa A Atriss, DO

  • Student in an Organized Health Care Education/Training Program
  • Detroit, MI
National Provider Identifier
1306537436
Registry record updated May 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
3031 W Grand Blvd Ste 600
Detroit, MI 48202-3014
Phone
(313) 871-3751
NPI assigned
May 18, 2023
Last updated
May 18, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MI Primary

Addresses

Primary practice location

3031 W Grand Blvd Ste 600
Detroit, MI 48202-3014

Mailing address

44272 Richmond CT
Canton, MI 48187-1919
Phone (480) 262-7991

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260402003399 MI Practitioner - Family Practice 6002299898 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

19000 St Joes Pkwy
Livonia, MI 48152-1477

2305 Genoa Bus Park Dr
Brighton, MI 48114-7005

4200 Whitehall Dr
Ann Arbor, MI 48105-9694

4400 Highland Rd
Waterford, MI 48328-1222
Phone (248) 618-6000

44428 Woodward Ave
Suite 102
Pontiac, MI 48341-5009
Phone (734) 712-8700

51341 W Huron River Dr
Trinity Health Iha Medical Group Primary Ca
Van Buren Township, MI 48111-2571
Phone (734) 997-0304

5505 S Old US
Brighton, MI 48116-7524

5505 S Old US 23
101 Thimg Lifestyle Medicine Primary Care E
Brighton, MI 48116-7524
Phone (734) 887-7888

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Detroit Wayne County Health Authority CurrentSince May 21, 2023 Accepting new patients

Locations

3031 W Grand Blvd
Ste 600
Detroit, MI 48202
Phone (313) 346-5235

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19827/brand/1/csg/1/fhir/r4
  • Direct secure messaging: mustafa.atriss.1@19827.direct.athenahealth.com

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1684368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1306537436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44272 RICHMOND CT",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481871919",
            "telephone_number": "480-262-7991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3031 W GRAND BLVD STE 600",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023014",
            "telephone_number": "313-871-3751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATRISS",
        "first_name": "MUSTAFA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-18",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.