NPIMap

Organization Active NPI

Ali Nasser MD PC

Doing business as Same

  • Primary Care Clinic/Center
  • Dearborn, MI
National Provider Identifier
1386839215
Registry record updated Jan 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
4301077843 Issued in MI
Legal business name
ALI NASSER MD PC
Doing business as
Same
Practice address
9925 Dix Ste 103
Dearborn, MI 48120-1593
Phone
(313) 843-8300
NPI assigned
Sep 13, 2007
Last updated
Jan 21, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
ALI NASSER MD PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 21, 2021

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

Authorized official

Name
Dr. Ali Mohamed Nassser, MD
Title
President
Phone
(313) 843-8300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 4301077843 MI Primary

Addresses

Primary practice location

9925 Dix Ste 103
Dearborn, MI 48120-1593

Mailing address

PO Box 4186
Dearborn, MI 48126-0186
Phone (313) 843-8300

Other identifiers 2

IdentifierTypeStateIssuer
1108227222OtherMIBLUE CROSS BLUR SHIELD
4627749MedicaidMI

Other names 1

  • Same Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040622000857 MI Part B Supplier - Clinic/Group Practice 6608851811 Receives reassigned benefits from 7 practitioners
Practice locations: Dearborn, MI

National Provider Directory

National Provider Directory
Part of
Ali Nasser MD PC

Practitioners & affiliated clinicians

Practitioners 7

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": "1189641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611187200000",
    "number": "1386839215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4186",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481260186",
            "telephone_number": "313-843-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9925 DIX STE 103",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481201593",
            "telephone_number": "313-843-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALI NASSER MD PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ALI NASSER MD PC",
        "enumeration_date": "2007-09-13",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A",
        "authorized_official_last_name": "NASSSER",
        "authorized_official_first_name": "ALI",
        "authorized_official_middle_name": "MOHAMED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-843-8300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MI",
            "license": "4301077843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUR SHIELD",
            "identifier": "1108227222",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4627749",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Same",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 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.