Individual provider Active NPI

Mohamed Nael Tarakji, M.D.

  • Neurology Physician
  • Flint, MI
National Provider Identifier
1336241082
Registry record updated Feb 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
MT048739 Issued in MI
Practice address
5082 Villa Linde Pkwy
Flint, MI 48532-3411
Phone
(810) 720-1335
Fax
(810) 720-1373
NPI assigned
Sep 2, 2006
Last updated
Feb 27, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X MT048739 MI Primary

Addresses

Primary practice location

5082 Villa Linde Pkwy
Flint, MI 48532-3411

Mailing address

5082 Villa Linde Pkwy
Flint, MI 48532-3411
Phone (810) 720-1335

Other identifiers 1

IdentifierTypeStateIssuer
3069447MedicaidMI

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
I20051101000032 MI Practitioner - Neurology 1658398524 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Flint Neurological Centre PCGroup PAC ID 1759308620, 5 clinicians

Practice addresses (Care Compare)

5082 Villa Linde Pkwy
Flint, MI 48532-3411
Phone (810) 720-1335

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT048739MIMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Flint Neurological Centre PC CurrentSince Jul 1, 1993 Accepting new patients

Locations

1501 S Center Rd
Bldg B
Burton, MI 48509
Phone (810) 742-0225

5082 Villa Linde Pkwy
Flint, MI 48532
Phone (810) 720-1335

5082 Villa Linde Pkwy
Ste 6
Flint, MI 48532

Organizations & group practices 1

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 3

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": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488153600000",
    "number": "1336241082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5082 VILLA LINDE PKWY",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323411",
            "telephone_number": "810-720-1335",
            "fax_number": "810-720-1373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5082 VILLA LINDE PKWY",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323411",
            "telephone_number": "810-720-1335",
            "fax_number": "810-720-1373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARAKJI",
        "first_name": "MOHAMED",
        "middle_name": "NAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2017-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "MT048739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3069447",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.