Individual provider Active NPI

Ali Elias Dia, FNP-BC

  • Family Nurse Practitioner
  • Detroit, MI
National Provider Identifier
1386100832
Registry record updated Feb 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704291293 Issued in MI
Practice address
3456 W Vernor Hwy
Detroit, MI 48216-1551
Phone
(313) 254-9693
NPI assigned
Feb 20, 2019
Last updated
Feb 20, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704291293 MI Primary

Addresses

Primary practice location

3456 W Vernor Hwy
Detroit, MI 48216-1551

Mailing address

23150 Wilson Ave
Dearborn, MI 48128-1853
Phone (313) 614-6115

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210423001708 MI Practitioner - Nurse Practitioner 0244648624 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704291293MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vernor Urgent Care PLLC CurrentSince Jan 22, 2021 Accepting new patients
Van Buren Urgent Care Center PLLC CurrentSince Jan 22, 2021 Accepting new patients
Vernor Urgent Care PLLC PastSince Jan 22, 2021 Accepting new patients

Locations

3456 W Vernor Hwy
Detroit, MI 48216
Phone (248) 720-8600

11650 Belleville Rd
Ste 101
Van Buren Township, MI 48111
Phone (734) 699-9888

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1550620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550620800000",
    "number": "1386100832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23150 WILSON AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481281853",
            "telephone_number": "313-614-6115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3456 W VERNOR HWY",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482161551",
            "telephone_number": "313-254-9693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIA",
        "first_name": "ALI",
        "middle_name": "ELIAS",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-20",
        "last_updated": "2019-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704291293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.