Individual provider Active NPI

Mai Shoua Xiong, NP-C

  • Nurse Practitioner
  • Warren, MI
National Provider Identifier
1417313727
Registry record updated Jan 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704281958 Issued in MI
Practice address
11800 East 12 Mile Road
Warren, MI 48093
Phone
(586) 573-5215
NPI assigned
Jan 4, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704281958 MI Primary

Addresses

Primary practice location

11800 East 12 Mile Road
Warren, MI 48093

Mailing address

11105 Marsha Place
Warren, MI 48089
Phone (586) 596-9013

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
I20161011001613 MI Practitioner - Nurse Practitioner 1355639147 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
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)

15959 Hall Rd
Suite 104
Macomb, MI 48044-5364
Phone (586) 884-2688

2078 E Big Beaver Rd
Beaumont Urgent Care of Michigan
Troy, MI 48083-2301
Phone (248) 918-0744

50958 Gratiot Ave
Chesterfield, MI 48051-3134
Phone (586) 265-2262

Hospital & facility affiliations

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704281958MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstreet Urgent Care of Michigan CurrentSince Feb 2, 2020 Accepting new patients
Wellstreet Urgent Care of Michigan PastSince Aug 6, 2023 Accepting new patients

Locations

2078 E Big Beaver Rd
Troy, MI 48083
Phone (248) 855-4134

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1451865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451865600000",
    "number": "1417313727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11105 MARSHA PLACE",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "48089",
            "telephone_number": "586-596-9013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11800 EAST 12 MILE ROAD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "48093",
            "telephone_number": "586-573-5215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "XIONG",
        "first_name": "MAI",
        "middle_name": "SHOUA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-04",
        "last_updated": "2016-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704281958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.