Organization Active NPI

Amer Aboukasm MD PLLC

  • Neurology Physician
  • Grosse Pointe Park, MI
National Provider Identifier
1356913867
Registry record updated Jul 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
AMER ABOUKASM MD PLLC
Practice address
1051 Yorkshire Rd
Grosse Pointe Park, MI 48230-1449
Phone
(313) 640-4656
NPI assigned
Jul 14, 2021
Last updated
Jul 14, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2021

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

Authorized official

Name
Amer Aboukasm, MDNPI 1194754085
Title
President
Phone
(313) 460-4664

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

1051 Yorkshire Rd
Grosse Pointe Park, MI 48230-1449

Mailing address

20816 E 11 Mile Rd Ste 201
Saint Clair Shores, MI 48081-1578
Phone (586) 285-5783

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210727000702 MI Part B Supplier - Clinic/Group Practice 9931502069 Receives reassigned benefits from 1 practitioner
Practice locations: Grosse Pointe Park, MI

National Provider Directory

National Provider Directory

Locations

20816 E 11 Mile Rd
Ste 201
Saint Clair Shores, MI 48081

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1626220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626220800000",
    "number": "1356913867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20816 E 11 MILE RD STE 201",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480811578",
            "telephone_number": "586-285-5783",
            "fax_number": "586-585-9066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 YORKSHIRE RD",
            "city": "GROSSE POINTE PARK",
            "state": "MI",
            "postal_code": "482301449",
            "telephone_number": "313-640-4656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMER ABOUKASM MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-14",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A",
        "authorized_official_last_name": "ABOUKASM",
        "authorized_official_first_name": "AMER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-460-4664",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grosse Pointe Park, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.