Ibrahim Humaisan

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601009923 Issued in MI

Practice address

10140 Vernor Hwy
Dearborn, MI 48120-1515

Phone

(313) 438-6059

NPI assigned

Jun 17, 2020

Last updated

Jan 26, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Wayne State University School of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellstreet Urgent Care of MichiganGroup PAC ID 6305188491, 129 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130

Merit-based Incentive Payment System (MIPS)

Final score

76.04 of 100Reported as group

Quality

67.93

Promoting interoperability

100

Improvement activities

40

Cost

52.21

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
• Direct secure messaging: ibrahim.humaisan.1@22301.direct.athenahealth.com
• Direct secure messaging: ihumaisan2371565@epic00.corewelldirect.org

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.

• Wellstreet Urgent Care of Michigan

  dba Corewell Health Urgent Care

  • Urgent Care Clinic/Center
  • West Bloomfield, MI
  • NPI 1578048096
  Medicare reassignment Care Compare group
• Michigan Healthcare Professionals PC

  • Internal Medicine Physician
  • Farmington Hills, MI
  • NPI 1295023547
  Medicare reassignment
• Michigan Healthcare Professionals PC

  dba Millennium West Diagnostic Center

  • Diagnostic Radiology Physician
  • Westland, MI
  • NPI 1043559404
  NPD
• Michigan Healthcare Professionals PC

  dba Urology Specialist of Michigan

  • Durable Medical Equipment & Medical Supplies
  • Lapeer, MI
  • NPI 1992693303
  NPD
• Wellstreet Urgent Care of Michigan

  • Non-Pharmacy Dispensing Site
  • Troy, MI
  • NPI 1649952052
  NPD (past)

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

• William Beaumont Hospital

  dba Beaumont Hospital, Troy

  • General Acute Care Hospital
  • Troy, MI
  • NPI 1306825997
  Care Compare affiliation
• William Beaumont Hospital

  dba Beaumont Hospital, Royal Oak

  • General Acute Care Hospital
  • Royal Oak, MI
  • NPI 1689653305
  Care Compare affiliation
• William Beaumont Hospital

  dba Beaumont Hospital, Grosse Pointe

  • General Acute Care Hospital
  • Grosse Pointe, MI
  • NPI 1932396017
  Care Compare affiliation

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

{
    "created_epoch": "1592352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737849600000",
    "number": "1326664194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1769 WALNUT ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481244025",
            "telephone_number": "313-655-4809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10140 VERNOR HWY",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481201515",
            "telephone_number": "313-438-6059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMAISAN",
        "first_name": "IBRAHIM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-17",
        "last_updated": "2025-01-26",
        "certification_date": "2025-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601009923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shonalee Dawn Hughes
• Kaitlin Shay Hughett
• Fralina Hulet
• Addison Hullinger
• Hana Humaisan
• Mercedes L Humbert, LMSW
• Humberto Bernal MD PC
• Chad M Humes Sr.
• Destini Nichole Hunt
• Matthew Joseph Hunt, DO

• Physician Assistant in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.